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 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 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.

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.

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.

ObjectiveTo investigate the distribution and expression of y-secretase subunit (APH-1)in the central nervous system (CNS) of APP/PS1 double transgenic Alzheimer's disease (AD) adult mouse model,and to detect the expression difference of APH-1 in developmental brain between AD model mouse and wild-type littermates in order to further clarify the relationship between APH-1 and AD. MethodsOffspring bred by APP/PS1 double transgenic AD mice were genotyped.Immunohistochemical staining was used to detect APH-1 distribution and expression in the CNS of adult APP/PS1 double transgenic AD mouse model,in the brain of AD model mouse and its wild-type littermates on postnatal day 1,7,21 and 120.Results APH-1 was widely expressed in almost all regions of the CNS,especially in the cerebral cortex,hippocampus,olfactory bulb,hypothalamus,ventral striatum,caudate putamen,raphe magnus nucleus,cerebellum,brainstem and spinal cord of the adult APP/PS1 double transgenic mice.APH-1 expression was higher in the cortex of both AD and wild type mouse on postnatal day 1 than on postnatal day 7 and 21 with increased level of APH-1 protein in adult mouse brain.APH-1 expression in the brain of AD mice was higher than in its wild type littermates at any stage(P＜0.05).Conclusions Distribution of APH-1 is ubiquitous and region-dependent in the CNS.The different distribution and expression between APP/PS1 double transgenic mouse model and its wild type littermate indicate that APH-1 may be related to AD.

Objective To investigate the association between polymorphism of HLA-DRB1 allele and systemic sclerosis (SSc) and scleroderma-associated renal damage in Han Chinese of Henan Province.Methods Eighty-one SSc patients and 90 normal controls were recruited in this study,among them 59 patients had renal damage (SRD).The genotyping was carried out by nest PCR-SBT and gene clone.Comparisons between groups were performed with x2 test or exact probabilities.Multivariable Logistic regression was used to evaluate the association between prevalence of SSc or SRD and the possible relevant alleles.Results Thirty-three HLA-DRB1 alleles were discovered from the specimens,including 27 in SSc specimens,and 22 in SRD.Among them,the allele frequencies of HLA-DRB1 * 040501 (8.64％), * 110101 (11.11％), * 150201(8.02％) were higher in SSc patients than those of the controls (1.67％,4.44％,2.22％ respectively).After adjusted for other factors,HLA-DRBl * 040501 (P=0.010,OR =5.839,95％CI:1.518-22.460)、* 110101(P=0.019,OR=3.060,95％CI:1.204-7.772)、* 150201(P=0.010,OR=4.780,95％CI:1.444-15.821 )were identified as independent risk factors for SSc.And the allele frequencies of HLA-DRB1*040501 (9.32％),* 150201 (7.63％) were higher in SRD patients than those of the controls (1.67％,2.22％ respectively).After adjusted for other factors,HLA-DRB1 * 040501 (P=0.008,OR=6.363,95％CI:1.614-25.087) and * 150201 (P=0.030,OR =4.043,95 ％CI:1.147-14.243 ) were identified as independent risk factors for SRD.Conclusion Our data suggest that HLA-DRB1 * 040501,* 110101,* 150201 may be susceptible genes for SSc and the HLA-DRB1 * 040501,* 150201 may be susceptible genes for SRD in Han Chinese of Henan Province.

Objective To evaluate if expression of serum retinol-binding protein 4 (RBP4) concentrations in cholesterol gallstone disease.Methods Serum RBP4 levels of 100 cholesterol gallstone disease patients (cholesterol gallstone disease group) and 147 healthy controls (healthy control group) were measured by enzyme-linked immunosorbent assay and further correlated with clinical and biochemical characteristics,including insulin resistance and renal function.The chemical composition of gallstones was determined by postoperative pathology.Results The level of RBP4 in cholesterol gallstone disease group was significantly lower than that in healthy control group [(30.57 ± 13.64 ) mg/L vs.(41.52 ± 20.25 ) mg/L](P＜ 0.01 ).The level of RBP4 was also associated with gallstone occurrence (OR =0.93,95％ CI:0.88 -0.96,P =0.004).Serum RBP4 levels of all subjects were positively correlated with total cholesterol,triglyceride,creatinine,insulin resistance and albumin ( P ＜ 0.05 or ＜ 0.01 ),and negatively correlated with aspartate aminotransferase (P ＜0.01).In multivariate analysis,cholesterol gallstone formation was significantly associated with a lower serum RBP4 level (OR =2.97,95％ CI:1.15 -7.68,P =0.025 ).Both gallstone patients and controls were subdivided into two groups according to ceatinine:≥ 88.40 μ mol/L group and ＜ 88.40 μ mol/L group.Patients with gallstones were found to have significantly lower serum RBP4 levels than controls in both subgroups (P =0.012,0.045 ).According to GFR,both gallstone patients and controls were subdivided into ≥ 90 ml/(min· 1.73 m2) group,60 - 89 ml/(min· 1.73 m2) group and ＜60 ml/ (min· 1.73 m2) group.It showed that a lower GFR was associated with greater serum RBP4 level in healthy control group.This trend was not noted in cholesterol gallstone disease group.Conclusions Serum RBP4 decreases in cholesterol gallstone disease independent of renal function.The relationship between liver function and RBP4 level in these patients deserves further investigation.