Compared with the 39 cases with T2DM treated by SU+metformin,the 43 T2DM patients treated by SU+metformin+rosiglitazone for 12 weeks had the improved glycemic and lipid profile controls,increased insulin sensitivity,and decreased CRP level(all P

Animals ; Antineoplastic Agents, Phytogenic ; isolation & purification ; pharmacology ; Cholesterol ; biosynthesis ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; HIV Protease ; metabolism ; HIV Protease Inhibitors ; pharmacology ; Humans ; Plants, Medicinal ; chemistry ; Platelet Aggregation ; drug effects ; Polysaccharides ; isolation & purification ; pharmacology ; Reishi ; chemistry ; Sterols ; isolation & purification ; pharmacology ; Triterpenes ; isolation & purification ; pharmacology

Objective To investigate the clinical efficacy of buttress plating for patients with posterior pilon fracture.Methods From April 2012 to January 2015,12 patients with posterior pilon fracture of the distal tibia were treated in our hospital.They were 7 men and 5 women,30 to 56 years of age (average,41.2 years).According to the CT classification by Haraguchi et al.,5 cases belonged to type I,3 to type Ⅱ and 4 to type Ⅲ.All the patients underwent open reduction and internal fixation with buttress plate via either a posterolateral approach or a dual posterolateral-posteromedial approach.All the patients were available for follow-up.The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS).The radiological evaluation was performed using the osteoarthritis-score (OA-score).Results The patients obtained an average follow-up of 21.2 months (range,from 12 to 30 months).Bone fractures united after an average of 15 weeks (range,from 13 to 19 weeks).The time for full weight walking averaged 16 weeks,ranging from 15 to 23 weeks.The ankle plantar flexion ranged from 36° to 42° (average,40.4°);the ankle dorsal extension ranged from 38° to 44° (average,42.6°).At the final follow-ups,the AOFAS scores ranged from 82 to 97 (average,88.2);the OA-score ranged from 0.6 to 0.8 (average,0.71);the VAS scores during rest,active motion and weight-bearing walking ranged from 0.5 to 0.8 (average,0.66),from 0.6 to 0.9 (average,0.82) and from 1.2 to 1.8 (average,1.41),respectively.No fracture malunion,implant loosening,pain or stiffness of the affected ankle was observed at the final follow-ups.Conclusion Buttress plating for posterior pilon fractures can lead to satisfactory clinical outcomes,because it ensures rigid fixation which in turn enables earlier postoperative mobilization.

Objective To investigate the effects of co-exposure to LPS and heat on plasma tumor necrosis factor-? (TNF-?) and interleukin-6 (IL-6) in rats. Methods Eighty male pathogen-free Wistar rats were randomly assigned to 4 groups: saline-injected normothermic control (group C), saline-injected heat exposed (group H), LPS-injected normothermic control (group L), LPS-injected heat exposed (group HL). Rectal temperature (Tr), heart rate (HR), mean arterial pressure (MAP), and respiratory rate (RR) were continually monitored. Plasma levels of TNF-? and IL-6 were determined at 0, 40, 80, 120 min after treatment. Results The rats in group HL displayed significantly higher values of Tr , HR , and RR and lower values of MAP than that of group C at 120 min. There was a significant difference in the values of HR and MAP between group HL and the other 3 groups at the same time point. The rats in group HL displayed an early rise in levels of plasma TNF-?, IL-6 at 40 min. The significant elevation of the peak TNF-? level at 80 min in group HL was observed. Plasma IL-6 hyperexpression was shown in rats in group HL which was significantly higher than the other 3 groups at the same time point. Conclusion Co-exposure to LPS and heat induces the rat to develop and augment systemic inflammatory response syndrome.

Objective To evaluate the effects of sepsis on pharmacodynamics of rocuronium in rats.MethodsForty SD male rats weighing 250-350 g were randomly divided into 3 groups: control group(group C,n =10) ; sham operation group(group S,n =10)and sepsis group (group Sep,n =20).Cerum was ligated and perforated to produce sepsis model in Sep group,rocuronium 3.81 mg/kg was intravenously injected at 6 or 16 h after operation,each time contains 10 rats.Cecum was not ligate and perforate in group S,but rocuronium 3.81 mg/kg was intravenously injected at 6 h after operation.Onset time,TOF no reaction period,duration of peak effect,clinical duration,totel duration,time for recovery of T1 to 10％,25％,50％,75％,90％ and recovery index were recorded by RM6240B signal acquisition and processing system.ResultsCompared with groups C and S,onset time was significantly prolonged,TOF no reaction period,duration of peak effect,clinical duration,total duration and time for recovery T1 to 10％,25％,50％,75％,90％ and recovery index were shortened in group Sep ( P ＜ 0.05).Onset time was significantly prolonged,time for recovery of T1 to 75％ was shortened when rocuronium injection at 16 h after operation as compared with that at 6 h after operation in group Sep( P ＜ 0.05).ConclusionSepsis can attenuate the effects of nondepolarizing neuromuscular blocker rocuronium,the degree is related to the stage of sepsis.

The paper introduces the common methods for automatic de-identification of clinical texts,including the method based on rules,machine learning method,comprehensive method,etc.,states the challenges for clinical texts practicability,system universality and scalability of clinical texts de-identification research,analyzes the further research direction,and provides reference for researchers of this field.

Objective To explore the clinical application value for calculating the volume of splenic embolization by splenic artery branch diameter ratio method.Methods Data of 20 patients with cirrhosis and hypersplenism who underwent partial operation of splenic artery embolization were retrospectively analyzed.Based on the angiography of splenic artery during operation,the diameter of branch vessels of splenic artery was measured and the percentage of embolism volume in spleen was calculated.CT scans were performed on all patients after one month of the operations.Based on VR reconstruction image,the percentage of embolism volume in the spleen was calculated.Postoperative complications and adverse responses were observed.Peripheral blood red cells,white blood cells and platelets were tested repetitively three days before the operation,and a week,a month,three months after the operation.Moreover,the statistical analysis was performed.Results The difference between the percentage of embolism volume in the spleen calculated by splenic artery branch diameter ratio method ([52.15±3.29]％) and calculated by CT ([49.99±6.02]％) was not statistical (t=-1.630,P=0.120).All the patients had moderate or below moderate pain on left upper quadrant,and had symptoms of nausea,vomiting and fever after the operation.They all got better after symptomatic treatment.Peripheral blood red cells,white blood cells and platelets all had significant differences among three days before the operation,a week,a month and three months after the operation (all P＜0.001).Conclusion During the partial splenic embolization,the application of ratio method on branch vessels of splenic artery to measure the volume of embolism in the spleen is convenient,prompt and relatively accurate.It is worthy to be expanded in clinic.

Objective To study the cell toxicity of thrombin in astrocytes in vitro and the protective effect of hirudo extract liquid (HEL) on the injured astrocytes. Methods Astrocytes were isolated from Wistar rats' cerebral cortex and cultured in vitro, and observed under a phase contrast microscope for growth status. Cell activity was measured with MTT assay. The survival of astrocytes was investigated after exposed to a selected concentration of thrombin ranging from 0.1 to 100 U/mL or to HEL ranging from 0.25 to 4 mg/μL by observing cell morphology under an inverted phase-contrast microscope and measuring the lactate dehydrogenase (LDH) activity (a marker of cell death) in cell supernatant. Expressions of HSP70 and TGFβ-1 protein in astrocytes were investigated by immunohistochemistry. Results (1) Thrombin (1-100 U/mL) had toxicity on astrocytes in vitro in a dose-dependent manner (F=118.65, P=0.000). (2) HEL (0.25-4 mg/μL) could significantly reduce the cell toxicity of 10 U/mL thrombin in astrocytes (F=156.08, P=0.000). With the increasing concentration of HEL, the protection of HEL was accordingly enhanced, and it even increased the expressions of HSP70and TGFβ-1. Conclusions HEL could accelerate the proliferation of astrocytes, enhance the expressions of HSP70 and TGFβ-1 protein, so as to significantly depress the cell toxicity of thrombin to astrocytes.

OBJECTIVETo compare the efficacies of portal vein stenting and transcatheter arterial chemoembolization (TACE) combined therapy performed with or without endovascular implantation of iodine-125 (125I) seeds strand in patients with hepatocellular carcinoma (HCC) and main portal vein tumor thrombus (MPVTT).

METHODSOne-hundred-and-six patients with HCC complicated by MPVTT who were treated with portal vein stents and TACE, either with (Group A, n=56) or without (Group B, n=50) endovascular implantation of 125I seeds strand, between July 2005 and April 2011, were retrospectively analyzed. Overall survival, stent patency, and procedure-related adverse events were compared between the two groups.

RESULTSThe technical success rate was 100% for placement of 125I seeds strands and stents in the obstructed main portal vein. No serious procedure-related adverse events were recorded. Group A had significantly higher median survival (335 days vs. group B: 146 days; P=0.001, hazard ratio (HR)=2.244). Additionally, group A had significantly higher median stent patency (400 days vs. group B: 190 days; P=0.005, HR=2.479).

CONCLUSIONThe combination therapeutic strategy of portal vein stenting and TACE with endovascular implantation of 125I seeds strands improves the survival of HCC patients with MPVTT complication.

Carcinoma, Hepatocellular ; complications ; therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Female ; Humans ; Iodine Radioisotopes ; administration & dosage ; therapeutic use ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Neoplastic Cells, Circulating ; Portal Vein ; physiopathology ; surgery ; Retrospective Studies ; Stents ; Treatment Outcome ; Venous Thrombosis ; complications ; therapy

ObjectiveTo investigate clinical application of intraoperative intraperitoneal hyperthermic chemotherapy using sustained-release fluorouracil in radical gastrectomy for advanced gastric cancer.MethodsThe clinical data of 280 advanced gastric cancer patients admitted from September,2002 to September,2010 were analyzed retrospectively.They were divided into three groups randomly and followed up.The postoperative morbidity,the mortality and the overall survival rates were evaluated.ResultsThere were no significant differences in these three groups with respect to postoperative morbidity ( P ＞ 0.05 ).The incidence of recurrence in intraperitoneal chemotherapy using sustained-release fluorouracil ( treatment group) was significantly lower than those of intraperitoneal chemotherapy and operative treatment( 16.18％,37.61％ and 41.28％,P ＜0.05).The 1,3- and 5-year overall survival rates of treatment group were 85.51％,61.28％ and 53.67％,respectively,and the 1-,3- and 5-year overall survival rates were 84.11％,39.98％ and 28.12％,and 81.28％,29.88％ and 25.21％ respectively in intrapeitoneal chemotherapy group and operative group.1-year overall survival rate had no significant differences among three groups with respect to ( P＞0.05).3-and 5-year overall survival rates in treatment group were higher signfficantly than those of intraperitoneal chemotherapy and operative treatment( P＜0.05).Conclusions Intraoperative intrapeitoneal hyperthermic chemotherapy using sustained-release fluorouracil is a kind of convenient,safe,and highly effective comprehensive treatment method,and it can kill isolated intraperitoneal cancer cells.It may reduce postoperative recurrence and improve survival rates.