Objective To investigate the effect of valsartan combined with ginkgo biloba extract (EGB) in the treatment of early diabetic nephropathy (DN). Methods All of 112 cases of early stage DN patients were randomly divided into treatment group (58 cases) and control group (54 cases). Two groups were given insulin to control blood gluoose and valsartan 80 mg/d. Meanwhile the treatment group was given EGB by intravenous infusion. The changes of urinary protein excretion rate (UAER), urinary β_2-microglobulin (β_2-MG), blood pressure, fasting glucose, serum creatinine (SCr), blood urea nitrogen (BUN), total cholesterol (TC), triglyceride (TG) were compared. Results There was no significant difference in UAER, β_2-MG, systolic blood pressure, diastolic blood pressure, FPG, BUN, SCr, TG and TC before treatment between two groups (P> 0.05). After treatment, they were improved in two groups compared with those before treatment(P < 0.05). Except for systolic blood pressure[(130 ± 13) mm Hg(1 mm Hg = 0.133 kPa) vs(129 ± 11) mm Hg], the improvement in treatment group was superior to that in control group(P<0.05). Conclusions Valsartan combined with EGB in treatment of early DN has significant synergies, and they can play roles with each other to prevent further deterioration of DN. This strategy is worthy to be popularized.

The human plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) is secreted, by the mature macrophages and lymphocytes, which predominantly binds to low-density lipoprotein. Studies in recent years have demonstrated that Lp-PLA2 plays an important role in the process of atherogenesis. Its gene polymorphisms are associated with the occurrence of ischemic stroke, and its specific inhibitor has anti-atherogenic effects. Lp-PLA2 may be a novel independent risk factor and a therapeutic target for ischemic stroke.

This research mainly analysed the section of clinical experience in the reporl of"A panoramic snapshot of medical students'education at the beginning of the 21st century"and gave a brief introduction to the mainstream medical education in No,hem Amercia according to the literature.At last,the enlightment from the report and reformation of our clinical practice were put forward.

Objective To analyze the influence of different types of seizures and nonepileptic events on peripheral white blood cell (WBC)counts. Methods We prospectively collected blood samples from all patients and detered WBC count to evaluate the relation of each type of seizure,duration,frequencies,and ttme lapse between a seizure and collection of blood sample to peripheral WBC count. Results Peripheral WBC count was elevated in about 50% cases after a generalized seizure. The length of a seizures was positively associated, whereas its frequencies and the lapse time was negatively correlated with the increase in WBC counts. Conclusion Peripheral WBC counts increase significantly after a generalized seizure.

Chronic pancreatitis is a chronic inflammatory disease of the pancreas,whichcan lead to irreversible damage to the morphology and function of the pancreas ultimately.So the early diagnosis and treatment for chronic pancreatitis are very important.And the differentiation between mass-forming chronic pancreatitis and pancreatic cancer is also a difficult problem in clinic.MRI as a noninvasive and nonradiative examination with excellent soft tissue resolution,is very valuable for the diagnosis of chronic pancreatitis.And the combination of functional MRI and conventional MRI is very helpful for the differentiation between pancreatic carcinoma and mass-forming chronic pancreatitis,which is of great significance to the clinical management.The application and progresses of function MRI in the diagnosis and identification of chronic pancrea titis were reviewed in this article.

Objective To observe the effectiveness of dexamethasone combined with azasetron for the prevention of postoperative nausea and vomiting(PONV) in patients after laparoscopic cholecystectomy(LC).Methods A total of 150 ASA(Ⅰ~Ⅱ) patients undergoing an elective LC were randomly divided into three groups with 50 patients in each group: Group D+A was given intravenous dexamethasone 5mg and azasetron 10mg(2ml) at the end of surgery,Group A received intravenous azasetron 10mg(2ml) at the end of surgery,and Group C received normal saline(NS) 2 ml as the control.Episodes of nausea and vomiting were recorded for 24 h following the surgery.Results The incidence of nausea was 4% in the Group D+A(2/50),which was significantly lower than in the Group A(16%,8/50) and the Group C(34%,17/50)(?~2=4.00 and 14.62;P=0.046 and 0.000).The incidence of vomiting was 2% in the Group D+A(1/50),which was significantly lower than in the Group A (14%,(7/50)) and the Group C(32%,16/50)(?~2=4.89 and 15.95;P=0.027 and 0.000).The incidences of nausea and vomiting were significantly lower in the Group A than in the Group C(?~2=4.32 and 4.57;P=0.038 and 0.033).Conclusions Use of a low dose of dexamethasone in combination with azasetron is more effective than azasetron prophylaxis alone for a successful control of PONV after LC.

Objective To evaluate the hypoxia selectivity of 99 Tcm O?labeld MAG3?nitroimidazole complexes with different spacers. Methods Four kinds of 99 Tcm O?labeled MAG3?2?nitroimidazole hypoxia imaging agents with different spacers were synthesized and radiolabeled. The stability and lipid solubility of BzMAG3?2NIEA(1), BzMAG3?2NIPA(2), BzMAG3?2NIHA(3) and BzMAG3?2NIUA(4) were measured. The uptake was investigated by biodistribution experiment using S180?bearing mice. Two?sample t test was used for statistical analysis. Results All 4 99 Tcm O?MAG3 complexes were stable and negatively charged, showing an increasing trend in fat solubility with the increase of spacer length. In biodistribution study, tumor uptake of 99TcmO?1 and 99TcmO?2 with medium? and short?carbon chain were (0.67±0.18) and (0?65±0.18) %ID/g 2 h post injection, which were (0.19±0.03) and (0.39±0.05) %ID/g for 99TcmO?3 and 99TcmO?4 with long?carbon chain (t=2.78-5.88, all P<0.05). Conclusion Molecular structure of spacers has a significant effect on the physicochemical properties and tumor targeting of 99 Tcm O?labeled MAG3?2?nitroimidazole hypoxia imaging agents, such that the medium?and short?carbon chain spacers show the best hypoxia?selective property.

Objective To evaluate the accuracy of systolic pressure variation (SPV) in monitoring blood volume in patients.Methods Twenty-two ASA Ⅱ or Ⅲ patients (17 male,5 female),aged 49-79 yr,with body height 153-173 cm,weighing 55-89 kg,scheduled for elective coronary artery bypass grafting under cardiopulmonary bypass,were studied.Stroke volume variation (SVV) was monitored based on the arterial pressure wave and SPV measured based on the invasive arterial pressure wave after changing the title.After the chest was closed,the volume load test was immediately carried out.6％ hydroxyethyl starch 130/0.4 50-80 ml/min was infused via the jugular vein until cardiac index (CI) increased by 10％.HR,mean arterial pressure (MAP),SPV,CI,SVV,stroke volume index (SVI),systemic vascular resistance index (SVRI),central venous pressure (CVP),and pulmonary capillary wedge pressure (PCWP) were recorded in supine position (T1),at 30° head-down tilt before skin incision (T1'),before (T2) and after opening the chest in supine position (T2'),before (T3) and after the volume load test in supine position after closing the chest (T3'),in supine position after skin closure (T4),and at 30° head-down tilt after skin closure (T4').The difference in SPV and SVV (△SPV and △SVV) was calculated.The receiver operator characteristic curve for △SVV and △ SPV in determining blood volume changes was plotted.Results MAP,CVP,PCWP,CI,and SVRI were significantly increased,while SVV and SPV were decreased at T1' compared with those at T1 (P ＜ 0.05).HR was significantly increased,while CVP was decreased at T2' compared with those at T2 (P ＜ 0.05).MAP,CVP,PCWP,and CI were significantly increased,while SVV and SPV were decreased at T3' compared with those at T3 (P ＜ 0.05).MAP,CVP,and PCWP were significantly increased,while SVV and SPV were decreased at T4' compared with those at T4 (P ＜ 0.05).The area under receive operator characteristic curve for △SVV and △SPV in determining blood volume changes was 0.603 and 0.616 respectively,and there was no significant difference (P ＞ 0.05).Conclusion SPV can accurately monitor the blood volume in patients.

BACKGROUND: It has vedfied that seaweed polysacchande-agarose modifiers have their medical application value. OBJECTIVE: To perform skin regeneration trials using sprayable activated agarose/gelatin solution, and to explore the possibility of egarose modifier as skin dressing for skin regeneration. METHODS: To prepare 3% sprayable mixture with the dissolved activated agarose and gelatin at a certain ratio, and then filtrated with millopore for sterilization to prepare activated agarose (egarose degradation for 8 hours) and gelatin degradation, and made into different ratios (1: 0, 1: 1, 1: 2, 1: 3). A total of four rabbits were obtained, and four sites were selected on the back of each rabbit, totally 16 experimental sites. The sprayable activated agarose/gelatin mixture (1: 1, 1: 2, 1: 3) was directly sprayed on the four lesion sites. Sprayable activated agarose for two sites and simple gelatin for two sites served as controls. The effects of the wounds sprayed with,dressing were observed at 4 weeks following surgery. RESULTS AND CONCLUSION: At 7 days following surgery, the cover film had broken in mixture of activated agarose and gelatin at 1: 3, and remaining three were intact. No infection or inflammation occurred in wound of four ratios. Following comparison, the wound was rapidly healed in 1: 2 ratio dressing. The additional gelatin showed promoting effects on wound healing significantly. Hematoxylin-eosin staining demonstrated that skin with the dressing was similar to autologous skin, which verified that sprayable activated agarose/gelatin have a premise in skin regeneration.

Objective To compare the proportion of CD3~+T cell and CD4~+CD25~(high) regulatory T cell (Treg cell) and the production of inferon γ ( IFN-γ) and interleukin-12 (IL-12) in peripheral blood mononuclear cells (PBMC) between patients with non-small cell lung cancer (NSCLC) and healthy people, and to analyze the changes of CD3~+T cell, CD4~+CD25~(high)Treg cell, IFN-γ and IL-12 of NSCLC patients before and after chemotherapy, so as to determine immune function changes of NSCLC patients caused by chemotherapy. Methods Twenty NSCLC patients and 20 healthy volunteers according to the including criteria were selected. Three mL of blood was drawn from NSCLC patients before chemotherapy (0 d), on the 3~(rd) day (3 d) and 7~(th) day (7 d) after chemotherapy. PBMC cells were separated from the blood samples. The proportions of CD4~+CD25~(high)Treg cell and CD3~+T cell (%) in PBMC were tested by FACS, and the IFN-γ and IL-12 (pg/mL) in the supernatants were also detected. Results The proportions of CD3~+T cell in NSCLC patients on 0, 3 and 7 d were (55.15±20.11)%,(57.73±14.08)% and (62.79±7.80)%,respectively, and there was no statistical difference between any two of these results. The proportion of CD4~+CD25~(high)Treg cell in healthy volunteers was (2.14±0.85)%, while that of NSCLC patients was (2.76±0.53)% on 0 d with statistical difference compared to the healthy volunteers (P<0.05). The CD4~+CD25~(high)Treg cell proportion (%) of NSCLC patients on 3 d and 7 d were (2.54±0.57)% and (2.72±0.29)%, respectively, which were both significantly lower than that of 0 d. On 3 d it was even much lower than that on 7 d (P<0.05). IFN-γ and IL-12 of NSCLC patients on 0 d were (34.36±4.38) pg/mL and (33.24±4.36) pg/mL, and no statistical difference was observed when compared with (34.36±4.38) pg/mL and (33.24±4.36) pg/mL in the healthy volunteers. On 3 d and 7 d, IFN-γ of NSCLC patients were (40.42±5.66) pg/mL and (39.27±6.07) pg/mL, respectively, and both were higher than that on 0 d (P<0.05); IL-12 of NSCLC patients were (35.51±5.03) pg/mL and (38.62±6.44) pg/mL, also both were higher than that on 0 d (P<0.05). Conclusions This study suggests that chemotherapy can improve immune functions of NSCLC patients, and may reinforce the anti-tumor immune response.