Objective To investigate the effects on the improvement of the function of islet β cell by three intensive insulin treatments on newly diagnosed type 2 diabetes(T2D) in different insulin resistant status.Methods Ninety-eight patients of newly diagnosed T2D were divided into two groups:group with overt insulin resistant status ( IR group) ( HOMA-IR ≥ 5 ); group without overt insulin resistant status ( Non-IR group) ( HOMA-IR ＜ 5).According to the condition of patient,there were six subgroups:IR-CSⅡ group ( n = 20 ); IR-glar group ( n = 22 );IR-aspart 30 group (n=23); Non-IR-CSⅡ group (n= 10); Non-IR-glar group (n=12); Non-IR-aspart 30 group (n = 11 ).Subgroups were treated with continuous subcutaneous insulin injection (CSⅡ group),insulin aspart plus insulin glargine ( glar group),and insulin aspart 30 injection ( aspart 30 group) for two weeks,respectively.The levels of fasting plasma glucose (FPG) ,fasting C-peptide(C-P) ,2 h plasma glucose (2 hPG) were measured and homeostasis model assessments of beta cell (HOMA-β) and homeostasis model assessments of insulin resistance ( HOMA-IR) were calculated using fasting C-P.Results The time of blood glucose recover,insulin dosage and the incidence of hypoglycemia of CSⅡ group were lower than those of the glar group and aspart 30 group( P ＜ 0.05 and P ＜0.01 ,respectively).However,there were no significant difference between the glar-group and aspart 30 group ( P ＞ 0.05 ).The insulin dosage of Non-IR-subgroups was significantly lower than the IR-subgroups ( P ＜ 0.01 ).The △HOMA-IR(C-P) of Non-IR-subgroups was lower than the IR-subgroups ( P ＜ 0.05 ).The △HOMA-islet(C-P) of the Non-IR-subgroups was higher than the IR-subgroups ( P ＜ 0.05 ).The △HOMA-IR(C-P) ( 1.79 ± 0.15 and 1.51 ±0.09 in IR and non-IR group,respectively) and △HOMA-islet(C-P) (4.01 ±0.21 and 4.35 ±0.23 in IR and Non-IR group,respectively) of the CSⅡ group were higher than those of the glar group (1.63 ± 0.21 and 1.40 ±0.19 of △HOMA-IR (C-P) and 3.86 ± 0.12 and 4.03 ± 0.18 of △HOMA-islet(C-P) in IR and Non-IR group,respectively) and aspart 30 group ( 1.61 ± 0.13 and 1.42 ± 0.1 1 ) △HOMA-islet (C-P) and 3.88 ± 0.32 and 4.01 ±0.14of△HOMA-islet(C-P)inIRandNon-IRgroup,respeetively)(P＜0.05).Conclusions Thethree intensive insulin treatments for newly diagnosed T2D accompanied with high blood glucose may improve the function of β cell and alleviate insulin resistance,especially the CSⅡ.However,the efficacy on T2D with overt insulin resistant status is limited.

Objective To explore the best time interval to extubate catheter for the postoperative gastric cancer patients,and provide the basis for early extubation after operation.Methods To collect 108 cases with gastric cancer in Department of Forensic Surgery of Yuncheng Central Hospital from March 2013 to February 2014 with indwelling catheter preoperatively.According to the admission sequence,they were divided into the observation group and the control group with 54 cases in each group,the observation group began clipping catheter in 10-15 hours after operation,extubating catheter within 24 hours after operation;the control group began clipping catheter on the second day after operation,and extubating catheter during 48-72 hours after operation.The time of extubation,urinary tract irritation symptoms,resetting catheters and the incidence of early postoperative ambulation in patients of two groups were observed.Results The incidence of urinary tract irritation was lower in the observation group than that of the control group [3.7％ (2/54) vs 16.7％(9/54)],the difference was statistically significant (x2=4.960,P＜0.05).Early ambulation compliance of the observation group was higher than that of the control group (complete compliance 52 vs.40,partial compliance 2 vs.8,no compliance 0 vs.6),the difference was statistically significant (x2 =10.565,P ＜0.05).Conclusions The method of extubation catheter within 24 hours after gastric canter operation can reduce the incidence of urinary tract irritation and improve early ambulation compliance.

Objective The recurrence and metastasis of malignant tumor could affect the survival of patients. Early detection of cancer cells in peripheral blood and effective therapy promptly are of clinical importance. The present study was to investigate the carcinoembryonic antigen (CEA) mRNA expression and serum CEA level in blood from patients with colorectal cancer and to evaluate its clinical significance. Methods Peripheral blood samples were collected from 35 eligible patients with colorectal cancer and 9 post operative patients. CEA mRNA was detected by reverse transcriptase polymerase chain reaction (RT PCR) and serum CEA was detected by time resolved fluorometric methods. Results The positive rate of CEA mRNA in blood samples of 35 patients with colorectal cancer was 45.7%, and 2.7% in healthy volunteers. Two of the nine post operative patients (22.2%) showed CEA mRNA positive. The positive rate increases with the pathological staging and showed no significant relation with the malignant extent of cell differentiation. Serum CEA mRNA positive rates in patients with CEA positivity (72.2%) were significantly higher than those in patients with negative CEA mRNA expression (42.3%).Conclusion The expression of CEA mRNA in peripheral blood cells correlates with the pathological staging of colorectal cancer and it could be of potential use to monitor the micrometastases of tumor. Long term follow up is needed to evaluate its clinical significance.

AIM:To find an efficient and simple surgical procedure of the external dacryocystorhinostomy ( EXT- DCR) in the treatment of chronic dacryocystitis.
METHODS:A total of 270 cases were performed in this retrospective study. A comparison of clinical effects and hemorrhage complications between the experimental group, in which 189 eyes of 167 patients that underwent traditional EXT-DCR without packing, and the control group, in which 121 eyes of 103 patients that underwent traditional EXT-DCR with Vaseline gauze were performed. The postoperative follow-up ranged from 6 to 36mo ( the mean follow-up was 15±3. 6mo).
RESULTS: There were no significant differences in the curative rates between the two groups (97. 9% vs 97. 5%, P>0. 05). But the incidence rate of moderate or severe postoperative nasal bleeding was lower in the experimental group (15. 9%, 30 eyes) than the control group (31. 4%, 38 eyes) and P<0. 01.
CONLUSION: The traditional EXT - DCR without packingis an effective procedure and is more effective in reducing moderate or severe postoperative bleeding when the intraoperative anastomose and the postoperative drainage are well done and the intraoperative bleeding is well controlled.

ObjectiveTo explore the cause and treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB) in patients with human immunodeficiency virus (HIV) infection. Methods24 cases with HIV and MDR-TB who were found in some AIDS-high areas in Henan were analyzed.ResultsAll cases were later-required drug-resistant ones. The main reasons were unreasonable plan for chemotherathy,improper management to the patients, side-effect of drugs,immunosuppression and low drug-tolerance. After anti-virus and 9～12 months long anti-tuberculosis chemotherathy,7 cases died and other 17 survival patients improved in clinical symptoms and signs, including no tubercle bacillus were found in sputum of 15 cases,the focal of infection were absorbed in 16 cases,the pulmonary cavity closure rate was 66.7%(4/6)and the count of CD4+ lymphocyte was higher than before.ConclusionThe patients with HIV and MDR-TB are difficult to cure and the mortality rate is high;the short-term effect of the anti-virus and multi-drug antituberculosis chemotherathy is better.

Graphite ; Humans ; Spectrophotometry, Atomic ; methods ; Vanadium ; urine

Chlorzoxazone ; blood ; Chromatography, High Pressure Liquid ; methods ; Cytochrome P-450 CYP2E1 ; blood ; Humans

One of the causes of the high cost of pharmaceuticals and the major obstacles to rapidly assessing the bioavailability and risk of a chemical is the lack of experimental model systems. A new pre-treatment technology, in vitro bionic digestion was designed for metal analysis in Lianhua Qingwen capsule. The capsule was digested on 37 degrees C under the acidity of the stomach or intestine, and with the inorganic and organic compounds (including digestive enzymes) found in the stomach or intestine, and then the chyme was obtained. Being similar to the biomembrane between the gastrointestinal tract and blood vessels, monolayer liposome was used as biomembrane model Affinity-monolayer liposome metals (AMLMs) and water-soluble metals were used for metal speciation analysis in the capsule. Based on the concentration of AMLMs, the main absorption site of trace metals was proposed. The metal total contents or the concentration of AMLMs in the capsule were compared to the nutritional requirements, daily permissible dose and heavy metal total contents from the "import and export of medicinal plants and preparation of green industry state standards". The metal concentrations in the capsule were within the safety baseline levels for human consumption. After in vitro bionic digestion, most of trace metals were absorbed mainly in intestine. The concentration of As, Cd, Pb was 0.38, 0.07, 1.60 mg x kg(-1), respectively, far less than the permissible dose from the "import and export of medicinal plants and preparation of green industry state standards".
Biological Availability ; Capsules ; adverse effects ; pharmacokinetics ; Digestion ; Drugs, Chinese Herbal ; adverse effects ; pharmacokinetics ; Humans ; Metals, Heavy ; adverse effects ; pharmacokinetics ; Models, Biological ; Stomach ; metabolism ; Trace Elements ; adverse effects ; pharmacokinetics

Catechols ; urine ; Chromatography, High Pressure Liquid ; methods ; Electrochemistry ; methods ; Humans ; Hydroquinones ; urine

Adult ; Coke ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Pyrenes ; pharmacokinetics ; Urine ; chemistry ; Young Adult