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.

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

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.

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 explore the effects of UVB on the expression of Gadd45a gene and DNA methylation levels in Jurkat cells. Methods Jurkat cells were irradiated with UVB of 1.0 J/cm2 and 1.5 J/cm2 respectively, and collected at 6, 12, 24 and 48 hours after the irradiation. Real-time RT-PCR was used to detect the mRNA expression of Gadd45a gene and methylation-sensitive genes CD11a and CD70. Global methylation level was also measured by MethylAmp global DNA methylation quantification kit. Results After irradiation with UVB at 1.0 J/cm2, the mRNA level of Gadd45a increased but global methylation level decreased at 6, 12, 24 and 48 hours, and significant changes were observed at 6 and 12 hours for the level of both Gadd45a mRNA expression and global methylation (P ＜ 0.01 or 0.05). Elevated mRNA expressions of CD11 a and CD70 were also noted in Jurkat cells after irradiation with UVB of 1.0 J/cm2, and significant elevation was observed at 12 hours (both P ＜ 0.05 ). After irradiation with UVB of 1.5 J/cm2, there was a statistical increase in the mRNA expressions of Gadd45a, CD11 a, CD70, together with a statistical decrease in global methylation level in Jurkat cells, at 6, 12, 24 and 48 hours (P ＜ 0.01 or 0.05). The mRNA expression of Gadd45a negatively correlated with the global level of DNA methylation in Jurkat cells (r = -0.395, P ＜ 0.05). Conclusion UVB irradiation can upregulate the expression of Gadd45a, but downregulate the global DNA methylation level in Jurkat cells.

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.

Purpose:To evaluate the effect of biological response modifiers for Ⅲ stage non-small-cell lung cancer.Methods:Fifty-nine patients were randomized into two groups.Twenty-nine patients were put into radiotherapy and chemotherapy(R+C) groups,thirty patients were into Biological response modifiers and radiotherapy chemotherapy(BRMS+R+C) groups.All patients received routine radiotherapy 2.0 Gy per day,5times a week to a total dose of 60-65 Gy,in 42-45 days.Radiation fields just covered clinical tumors.Chemotherapy consisted of cisplatin 25-30 mg/m 2 ,etoposide 50-70 mg/m 2 on days 1?2and 3 every 4 week,for squamous cell carcinoma.For adenocarcinoma,it was mitemycin 4-6 mg/m 2 on day1 and vindesine 3 mg on day1 and8,and cisplatin25-30 mg/m 2 on day1?2 and 3,every 4 weeks interferon-?(IFN-?)and interleukin-2(IL-2)were used in(BRMS+R+C)groups after the second chemotherapy was over. IFN-? was given on days 1?2?3 and IL-2 on days 2?4?6 to a total of forty-eight day.Results:The overall response rate was 51.7% and 76.6% in(R+C) and(BMRS+R+C) groups.The one.two year survival rates were 62.1% 17 3% and 83 3%,43 3% in (R+C) and (BMRS+R+C) groups respectively.Conclusions:The preliminary results from our study has shown that biological response modifiers combined with radiotherapy and chemotherapy for non -small cell lung cancer has better early response rate and survival rate.

Humans ; Noise, Occupational ; Occupational Exposure