Glucose insulin release test together with IGI (insulin genetic index) and determinations of some insulin-antagonistic hormones such as hGH (HPL), TT3, TT4, 135I-T3 MAA absorbing ratio were carried out in 90 normal pregnant women. The results indicated that (1) the fasting plasma glucose level was lower as compared with that of the non-pregnant control group, especially during the second trimester; (2) subclinical hypoglycaemia appeared in about 18% of the pregnant women during the first and second trimesters;(3) some insulin-antagonistic hormones, especially HPL (human placental lactogen), which was crossreactive to hGH, augmented load of pancreatic islet; (4) augmentation of load of pancreatic islet might be demonstrated by fasting hyperinsulinemia, elevation of postprandial plasma glucose level especially during the third trimester and increased IGI response during the second trimester-after glucose intake, It was suggested that pregnancy might lead to diabetic susceptibility, and that an over-weight or pregnant woman suspected of diabetes mellitus should be moni-tored carefully with OGTT during gestation.

Seventy-six cases of NIDDM were collected and divided into 2 groups at random. 40 cases were treated with MIG (micro-glibenclamide) and 36 with OVG (old version glibenclamide) for 3 months. All patients were monthly followed-up for FPG.IRI (im-muno-reaction insulin) ,C-P,FMN(fructosamine),blood lipids and their pharmacokinetic behavior. The results showed that the total effectiveness of MIG for FPG in MIG group (51. 3% ,57. 5% ,79. 5%)monthly were better than that in OVG group(47. 2% ,55. 9% ,45. 7%). The results also suggested that MIG had a better results after a 3-month therapy,the diminished value of HbA, with MIG was more marked than with OVG (P

Objective To investigate total serum homocysteine (tHcy) concentration in ischemic stroke patients and in carotid atherosclerosis patients in comparison with normal con trol elders and to evaluate whether providing folate and vitamin B 12 coul d decrease serum homocysteine concentration. Methods The sampl e in this study was obtained from the inpatients and outpatients of geriatric d epartment, Huashan Hospital. 160 patients were recruited and were divided int o two groups with smoking controlled. Thyroid gland abnormality and renal f a i lure were excluded. One group consisted of 71 male and 9 female ischemic strok e patients aged 73 years on average;There were 71 male, 9 female carotid ather osclerosis disease patients, aged 7 years on average in the second group. H y pertension and mellitus diabetes were controlled to avoid the influence of the f actors in these patients; the third group consisted of 72 male and 8 female norm al control elders, aged 71 years on average. Besides fast serum total homocyst e ine, every patient took laboratory and physical examinations,including plasma fo liate, vitamin B 12, free plasma glucose, creatinine, cholesterol, triglyce ride, blood pressure and blood mass index. Then each group was randomly subdivided in t o two groups in which one group was provided with folate 1.25 mg qod, and vitam in B 12 8?g qd w hile the other was not provited with folate and vitaminB 12. These patient s were reexamined after 10 months. Results The serum tHcy concentration was (16.1 ?5.3) ?mol/L in ischemic stroke group and (14.2?4.72) ?mol/L in caroti d athero sclerosis group compared with (12.5?3.0) ?mol/L in normal control elders ( P=0.000 1). The plasma foliate was low in ischemic stroke and carotid athe rosclerosis patients, and there were no significantly statistics dif ferences in the other examinations.Correlation analysis showed that tHcy was ne gatively correlated with foliate and vitamin B 12, r=-0.392,-0.36 r e spectively i n ischemic stroke group, r=-0.287,-0.339 respectively in carotid ath eroscleros is group, and r=-0.338,-0.227 in normal control group. The tHcy concent ration was lower in the groups provided with foliate and vitamin B 12 than that in the g roups without foliate and vitamin B 12 (P=0.000 1), even in the normal elders. Conclusions The tHcy concentration was higher in the patients with ischemic st roke and with carotid atherosclerosis. Folate supplement could moderately lowe r tHcy.

Objective To probe the changes of RAGEmRNA expression in renal tissue of.streptozotocin (STZ)-induced diabetic rats. Methods Quantitative reverse transcription polymerase chain reaction (RT-PCR) was used in control rats and diabetic rats for 12 weeks. Results After 4 weeks of diabetes inducement, RACEmRNA level showed a continuous increase both in diabetic renal cortex and medulla. However, this enhancement could not be observed in 2 weeks of diabetes. In addition, after 8 weeks diabetic rats had significantly higher glycated Hb(GHb). Conclusion Gene expression of RAGE in renal tissue of diabetic rats is altered and the excessive gene expression of RAGE may enhance the AGEs-RAGE interactions which would contribute to the development of diabetic nephropathy. Furthermore, this change occurs as a result of hyperglycemia-induced AGEs formation.

OBJECTIVE To investigate the oropharyngeal bacterial carriage in hospitalized elderly patients without acute infections and the antimicrobial resistance,and the risk factors for the bacterial carriage.METHODS An oropharyngeal swab was taken from each patient after they rinsed their mouths with sterile saline.Bacteria were cultured and identified with routine methods and the antimicrobial susceptibility testing was carried out with disk diffusion method.RESULTS The oropharyngeal bacterial carriage rate was 55.2% in elderly patients.Sixty two pathogens were isolated including 56(90.3%) strains of Gram-negative bacilli,5(8.1%) Gram-positive cocci and 1 Candida albicans.All of 34 strains of Haemophilus spp were susceptible to antimicrobials tested such as ampicillin and cefaclor,a few strains were resistant to gentamicin and ciprofloxacin.Of 10 strains of Klebsiella pneumoniae,4 strains were extended-spectrum ?-lactamases positive and resistant to cefotaxime.Logistic analysis indicated that denture-wearing was the risk factor for the oropharyngeal bacterial carriage in elderly.CONCLUSIONS Oropharyngeal bacterial carriage rate is high in hospitalized elderly patients.The major colonized bacteria are Gram-negative bacilli.Denture-wearing is the risk factor for the oropharyngeal bacterial carriage in elderly.

Objective To evaluate the efficacy and safety of alteplase (rt-PA) thrombolytic therapy on patients with acute ischemic stroke aged over 80 years old.Methods The observational cohort study were conducted.One hundred and thirty-six patients with acute cerebral infarction and received rt-PA thrombolytic treatment were selected as our subjects with incidence time of 4.5 h,and the rt-PA dose of 0.9 mg/kg.The patients were divided into ≥80 years old group(n =34) and ＜80 years old group(n =102).U.S.A national institutes of health stroke scale (NIHSS) score of two groups evaluated before thrombolysis,immediately after thrombolysis 24 h,7 d and 14 d.The incidence and mortality rate of intracranial hemorrhage (ICH) and symptomatic intracranial hemorrhage (sICH) of two group were compared; and the score of modified Rankin's Scale (mRS) followed-up of 90 d were evaluated.Results NIHSS score after thrombolysis 24 h,7 d and 14 d of two groups were significantly lower than that before thrombolysis,and the differences were statistically significant (t =4.123,9.936,9.679,5.657,8.154,6.956,P ＜0.01).The score after thrombolysis 24 h,7 d and 14 d of two groups were no statistically significant difference.The efficient rate of treatment of two group were 55.88％ and 61.76％ respectively(P =0.54).Mter follow-up of 90 d,the prognosis rate were 47.06％ and 64.71％ respectively(P =0.07),and there were no statistically significant difference.Incidence rate of ICH were 11.76％ and 5.88％ respectively(P =0.07).Occurrence rates of sICH were 5.88％ and 2.94％ (P =0.43).Mortality rate were 11.76％ and 9.80％ (P =0.33),and there were no statistically significant difference.Conclusion This study shows that 80 years of age or older patients with acute ischemic cerebral apoplexy patients using rt-PA intravenous thrombolytic therapy is safe and effective,but RCT need further study.

Telemedicine refers to two or more medical institutions using communication, computer, and network technology to provide remote diagnosis, treatment, and care for patients. The necessity and feasibility of applying telemedicine are determined by the characteristics of burn injury. This paper reviewed the application of telemedicine in burn surgery at home and abroad, then analyzed the significance and problems of using this technology in the field of burns, finally forecasted the future of application of telemedicine in burn surgery.