There have appeared many new insulin analogues in recently years. Two of them are rapid-acting insulin analogues(aspart,lispro).The regions between the insulin analog molecules were modified,which have shorter time than regular human insulin in onset of action,peak,duration of acting,and are better in decreasing postprandial glucose and opportunity of hypoglycemia before next meal.The another insulin analogues were galargine and detemir.They were obtained from changing insulin isoelectric point and increasing molecular weight,which lengthen time for disintegration,absorption and action and have little absorption variation and no overt peak.They can simulate physiological base insulin excretion.

Resistant starch is not absorbed in the small intestine.But it can be fermented in the large bowel.Recent studies have confirmed the ability of resistant starch to decrease postprandial blood glucose levels,decrease serum cholesterol and triglyeride levels,and enhance the sensitivity of insulin.As such,resistant starch contributes to preventing and treating metabolic syndrome.

Objective To investigate molecular typing and drug resistance patterns of 98 Klebsiella pneumoniae (K.pneumoniae) isolated from type 2 diabetes patients complicated with maxillofacial infection,to research the virulence and resistance mechanisms.Methods The study was a prospective study that adopted the method of continuous sampling from fixed location,from March 2010 to October 2012.The maxillofacial surgery patients diagnosed with type 2 diabetes complicated with maxillofacial infection were chosen in 7 hospitals in Zhengzhou as the research object,and a total of 431 pus sample were collected continuously,in which 98 strains K.pneumoniae were isolated and identified.The Kirby-Bauer disk diffusion test was conducted in 98 strains to determine the resistance to 19 antibacterial agents.K.pneumoniae chromosomal DNA were digested by restriction endonuclease Xba Ⅰ and analyzed by pulsed-field gel electrophoresis (PFGE).PFGE patterns of K.pneumoniae strains were analyzed using Fingerprinting software.The relationship between the molecular types and resistance phenotype was observed.The extended spectrum β-1actamase-producing K.pneumoniae were screened out by the double disc synergy test (DDST)Polymerase chain reaction (PCR) was used to detect resistant genotypes,serotype and virulence genes.The purified PCR products of resistant genes were cloned and sequenced.Hypermucoviscosity phenotype of all strains were determined by string test.Results Much severer drug-resistance for K.pneumoniae was identified and the result of extended-spectrum beta-lactamase producing rate was 57.1 ％.Ninety-eight strains were dispatched into 13 groups by PFGE.No dominant bands and specific extended-spectrum beta-lactamase DNA bands were found.The results of PCR showed that among the 56 strains of extended spectrum β-lactamase-producing K.pneumoniae,40 were positive for blaSHV (accounting for 71.4％),28 positive for blaTEM (accounting for 50.5％),21 positive for blaCTX-M (accounting tor 37.5％).The sequencing results were as follows:TEM-1,CTX-M-3 and a variety of SHV.Serotype K1,K2,K3,K5,K20,K54 and K57 and 3 kinds of virulence genes were detected,but not in strong toxicity-based.Hypermucoviscosity positive rate was 31.6％ (31/98).Conclusion Much severer drug resistance of K.pneumoniae in this study was identified and resistant mechanism was complex,in which strong toxicity serotype and virulence geues exist,which need more attention from clinical.

Objective To assess the value of serum N terminal pro-brain natriuretic peptide(NT-Pro-BNP) in the diagnosis of congestive heart failure(CHF) and evaluation of cardiac function in children with ventricular septal defect (VSD).Methods Fifty one children were enrolled from March 2004 to March 2005.NT-Pro-BNP was measured by enzyme immunoassay technique.At the same time,left ventricular ejection fraction(LVEF) and left ventricular shortening fraction(LVFS) were detected with echocardiography.Results The data of NT-Pro-BNP were showed but the logarithms of which were normal distribution.The values of NT-Pro-BNP were developed successively along with the severity of cardiac function.But there was no difference between the group of no heart failure and mild heart failure.But the values of LVEF and LVFS had no differences in the control,the mild and the moderate heart failure and the same time all of which beyond the standard of diagnosing heart failure.NT-Pro-BNP could reflect the degree of heart failure or cardiac function (r=0.826).But LVEF and LVFS can not reflect the degree of the cardiac function.Conclusions NT-Pro-BNP can reflect the degree of the cardiac function in VSD,and the degree of the heart failure can be classed by the levels of serum NT-Pro-BNP.But the value of LVEF and LVFS can not reflect the degree of the heart failure in the same disease.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Immunophenotyping ; Leukemia ; diagnosis ; immunology ; therapy ; Male ; Middle Aged ; Neoplastic Stem Cells ; immunology ; Prognosis ; Treatment Outcome ; Young Adult

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Boronic Acids ; administration & dosage ; therapeutic use ; Bortezomib ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage ; therapeutic use

ObjectiveTo compare the therapeutic effect of mininal]y invasive removal of intracranial hematoma and conservative treatment in curing hypertension cerebral hemorrhage of elderly patients.Methods60 patients with hypertension cerebral hemorrhage were divided into two groups.Group A were adopted minimally invasive removal of intracranial hematoma(YL-1 type puncture needle was used into the hematoma edge,and sucked slowly the hematoma), and group B were adopted medical treatment(antihypertensive drugs, dehydration, free radicals and nutrition conservative treatment) ,then clinical therapeutic effect and activity of daily living were observed.ResultsThe hematoma evacuation time in group A (4.5 ± 1.2) d is shorter than in group B (17.0 ± 1.9) d (t = 6.04 ,P ＜ 0.05) ; The rate of neurological function recovery in group A (66.7％) is higher than in group B(93.3％) (x2 = 5.46,P ＜0.05) ; The activity of daily living in group A (80.0％) was better than group B (50.0％) (x2 = 5.93, P ＜ 0.05).The complication rate in group A (30.0％) is lower than in group B (66.7％) (x2 = 8.08, P ＜ 0.05).ConclusionThe therapeutic effect of minimally invasive removal of intracranial hematoma in curing hypertension cerebral hemorrhage was better than medical treatment.

[Objective]To investigate the treating effect of bicondylar tibial plateau fractures with lateral supporting plate and compression screw system.[Method]Forty-six cases of bicondylar tibial plateau fractures were treated with internal fixation from the year of 2000 to 2004 in our hospital.All of them were treated with open reduction and internal fixation by lateral supporting plata and compression screw system.Orthopaedic evaluation at latest follow-up included a knee functional outcome and radiographic examination.[Result]Forty-six cases were followed up for 12 to 18 months(averaged,14.4 months).All fractures healed.According to Rasmussen scale,84.8% excellent and good results were obtained.[Conclusion]Most of all bicondylar tibial plateau fractures were stabilized by applying lateral supporting plate and compression screw system.This system help reduce complication rates resulting from open reduction and internal fixation.

[Objective]To analyze the clinical and radiographic outcome of surgical treatment for idiopathic scoliosis in patients treated at the age of 20 years or older.[Methods]In this study,62 adult patients with idiopathic scoliosis who underwent surgery using pedicle screw instrumentation were followed up for 2 to 5 years,and the results were analyzed clinically and radiographically.[Results]The prevalence of pain requiring specific treatment decreased from 16% to 4%,and the pain relieve was reliably obtained in the older patients.Radiographically,the mean correction rate of Cobb's angle was 56% for both the thoracic and lumbar curves,whereas it decreased with the age increasing,especially in relation to the thoracic curve.The sagittal plane correction was satisfactory.[Conclusion]This study clarified different specific characteristics and problems in the surgical treatment of adult idiopathic scoliosis in different age groups.Pain is the most important indication for surgery in patients older than 40 years,and it has been improved reliably by surgery in most of these patients.On the other hand,the correction rate of Cobb's angle would be decreased with the increased age,the sagittal plane correction rate is not related to age.

Objective To investigate the significance of human leukocyte antigen (HLA) matching in highly sensitized recipients of renal transplantation. Methods 18 highly sensitized recipients preexisting panel reactive antibody IgG (PRA IgG) and their specificities were detected by enzyme linked immunosorbent assay (ELISA) with lambda antigen tray (LAT and LATM). Donors and recipients HLA class I typing was performed using complement dependent cytotoxicity (CDC) test with special monoclonal tray (SMT) and HLA class II gene typing by micro sequence specific primers polymerase chain reaction (Micro PCR SSP). Results PRA IgG positive rate in 18 highly sensitized recipients was between 40%～96% with an average of 56%, patients with 0～1 or 2～3 mismatch (MM) of HLA A,B,DR antigen were 28%(5/18) and 72% (13/18) respectively according to the standard of conventional HLA antigen matching.Whereas cases with 0～1 or 2～3 MM of HLA crossreactive antigen groups (CREGs) were 11 (61%) and 7 (39%) respectively by the rule of CREGs matching and the cases with 0～1 MM increased 33%. Only 4 (22%) cases of posttransplantation developed acute rejection and was reversed by OKT 3 treatment. Conclusions The allocation based on CREGs matching should result in a significantly higher percentage of well matched between donors and recipients. Good HLA matching plays an important role in reducing the incidence of acute rejection and in improving the survival of grafts.