Berberine is the major component of Coptidis Rhizoma and it has been used as anti-infection, anti-inflammation drug for gastrointestinal diseases. In recent years, evidence showed that it could regulate glucose and lipid metabolism. Moreover, its activity had been tested by clinical trials and animal researches. The mechanisms of berberine in diabetes include: improving the function of beta-cell; prompting insulin secretion and islets regeneration, lowing lipid level, regulating glucose and lipid metabolic by influence transcriptional factors expression such as PPARgamma, C/EBPalpha, SREBP-1c, LXR, having the activities of anti-oxidation and inhibiting reductase to repress oxidative stress state and regulate metabolic signal pathway. Although numbers of data supported that berberine could improving insulin resistance by clinical trials and animal studies, the large scale, multicenter clinical trials are needed to evaluate the effects of berberine for diabetes and its complications in the time of evidence-based medicine.
Animals ; Berberine ; adverse effects ; therapeutic use ; Diabetes Mellitus, Type 2 ; drug therapy ; genetics ; metabolism ; Glucose ; metabolism ; Humans ; Hypoglycemic Agents ; adverse effects ; therapeutic use ; Insulin ; metabolism ; Lipid Metabolism ; drug effects

Objective To determine the content of ECEGC in Salacia amplifolia by HPLC.Method HYPERSIL C18 column was used with a mixture of methanol and water(30∶70) as mobile phase,and detected at 283 nm.Result The linear range was 0.444 8～7.116 8 ?g(r =0.999 9) for ECEGC.The average recovery was 100.30%.Conclusion The method is simple,rapid,accurate and reliable.

Objective To improve the efficiency of donated organs and to investigate the possi- bility and operation protocol of heart and lung transplantation from the same donor to different reci- pients.Methods The organs of heart and lung were obtained from three donors through the method of orthotopic lavage and whole cutting,and transplanted to end-stage patients with heart diseases or lung diseases.First,the donor was subjected to mechanical ventilation,thoracotomy and lavage of heart and lung.The heart and lung were cut in whole and separated.The recipients were subjected the re- trograde lavage of heart and lung.In the patients receiving unilateral lung transcription,the left and right lungs were isolated.Among 3 recipients of lung transcription,one underwent left unilateral lung transplantation and 2 bilateral lung transplantation.Three cases received orthotopic cardiac transplan- tation by using bicaval orthotopic heart transplantation (BOHT) anastomosis method.Results One recipient of left unilateral lung transplantation recovered well after operation.In one recipient under- going bilateral lung transplantation,right upper lung embolism occurred.After re-operation of cutting the right upper lung on the 9th day of the first one,he recovered from the illness.In another recipient receiving bilateral lung transplantation,anastomotic stenosis of trathea and pulmonary infection occurred after operation.After expectant treatment,he recovered from the illness,but died from serious infection 7 months after operation.One of the heart recipients was found having renal failure of first stage,and recovered from disease after hemodialysis treatment.Quality of life was good in all 3 heart recipients after operation and their heart function achieved the restoration of 0-Ⅰstage.Conclusion The treatment protocol of transplantation from the same donor to different recipients at the same time, which can make full use of the organs from donors,is feasible and has good effect.

Objective: To evaluate the clinical results of cryopreserved homografts for the treatment of complex congenital heart defects. Methods: In 420 patients with complex congenital heart diseases received surgical correction with right ventricular outflow tract (RVOT) reconstruction was done using cryopreserved homografts. Of the 420 homografts, 234 were aortic homografts and 186 were pulmonary homografts. The mean age of patients was 4.6 years (range, 5 months to 21 years). The mean body weight was 17.5 kg (range, 5.5～52 kg). The mean follow-up time was 27.8 months (range, 3 months to 12.9 years). Results: There were 19 operative deaths with a mortality rate of 4.5%. The postoperative complications occurred in 25 patients and they all recovered uneventfully. The postoperative mechanical ventilation time was 48.7±42.5 hours (range, 8～192 hours). The mean hospital stay was (12.2±9.0) days (range, 7～46 days). There were no late death and complication. Conclusion: The results of this study suggest that ROVT reconstruction with cryopreserved homografts as transannular patch can be achieved with excellent the clinical outcome.

Objective To explore the diagnostic value of CT-guided percutaneous lung biopsy for pulmonary solid lesions.Methods CT-guided percutaneous lung biopsy was performed in 97 cases of pulmonary solid lesions. The lesions were 2~10 cm (mean, 4.2 cm) in diameter, and the distance to the pleura was 0~8 cm (mean, 3.4 cm). Results Confirmative diagnoses were achieved in 73 cases of lung cancer and 21 cases of benign lesions (inflammation, tuberculosis, or sarcoidosis). The diagnostic rate was 96.9% (94/97). The biopsy could not indicate the accurate diagnosis in 3 cases, 2 of which were identified as having squamous cell carcinoma by operation, and 1 of which was followed for 2 years with no changes. Postoperative complications included 8 cases of pneumothorax, 2 cases of hemothorax, and 2 cases of emptysis. Conclusions CT-guided percutaneous lung biopsy is safe and offers a high diagnostic rate, especially suitable for lesions near the pleura.

Objective To compare the efficacy and safety of intravesical instillation of pirarubicin (T HP) to prevent the post -operative recurrence of superficial bladder cancer with same dose variable concentration .Methods A tota1 of 56 cases of superficial bladder cancer after transurethral resection (TURBT ) were randomly divided into two groups(High concentration group :25 cases , Low concentration group :31 cases) .Infusion dose of THP is 30 mg .The concentration of THP is 1 .0 g/L in H group ,0 .6 g/L in L group .Both groups were installed within 24 hours after operation .Both groups were installed once a week for 8 weeks after the first installation ,then once a month until 1 year after operation .All cases were followed up ,the tumor recurrence time ,recurrence rates and complications were compared .Results All cases except 2 in L group received 6 -30 months follow up ,with an average time of 17 .6 months .In H group ,1 patients recurred during the follow-up period ,with a recurrence rate of 4 .0% and recurrence time of 12 .4 months ,while in L group ,3 cases recurred ,with a recurrence rate of 10 .3% and an average recurrence time of 9 .8 months .Adverse reactions were main1y Urinary irritation symptoms .The difference of recurrence rate and average recurrence time in each group were statistically significant (P< 0 .05) ,while the difference of adverse reactions were not statistically significant (P>0 .05) .Conclusion This study shows that high concentration THP intravesical instillation could effectively reduce the recur-rence rate and delay the recurrence time .Each concentration was well tolerated .

Objective To probe the reasons of failure of caged cervical intervertebral fusion and define the indications, operative techniques and short term results of the revision surgery. Methods Twenty-seven cases of caged cervical fusion were revised. The indication for fusion was cervical disc herniation in four cases and cervical spondylotic mylopathy in 23 cases. Of the 27 cases, there were 8 single levels, 15 double levels, 4 three levels. The intervals from revision to primary fusion were 2-25 months, 10.3 months in average. Patients presented discomfort (22 cases) and local pain of neck and shoulder (9 cases) or paralysis (19 cases) preoperatively. JOA grade was mean 11.6 points before revision. Radiographic examination showed the mean lordosis loss was 7.1 mm, the mean interbody height loss was 3.9 mm. 24 patients presented kyphosis. Occluded neighboring cages were found in multilevel cases. Nonunion was founded in 6 cases, unstable in 9 cases, compression still existed in 19 cases. Removal of cages and then decompression, bone grafting and anterior plating fixation were performed in 23 cases (29 cages). 16 patients underwent further posterior fixation. Posterior revisions underwent in another 4 cases (9 cages), including laminectomy and reshaping the lordosis and lateral mass screw plating fixation. Results All the cases were followed-up from 4 to 26 months, 11.7 months in average. The local symptoms released in 81% patients. Nerural deficit symptoms improved in 58% patients. Mean JOA grade was 14.2 points after revision. In 23 cases of anterior approach revisions, 17 cases obtained bone healing within 3 months, while 6 cases got delayed union. The kyphosis was corrected, and the intervertebral height increased 3 mm in average. There were no nerural impaction or failed internal fixation. Conclusion Deficient decompression, sinking of the cage into the cancellous bone of the vertebral body and subsequent kyphosis and bone graft nonunion consist of the main causes for revision surgery. The indications of revision are aggressive neurologic symptom, unstable or deformity of the cervical spine. Cage removal, completely decompression, bone grafting and secure fixation are major steps of revision procedure. In case of more than 3 fusion levels, further posterior fixation is advised.

[Objective]To assess the clinical effect and radiological results of three methods of anterior cervical decompression and reconstruction for the treatment of multilevel cervical myelopathy.[Method]Fifty-two patients with continuous multilevel cervical myelopathy treated by the same team were divided into three groups.Group Ⅰ was performed the twosegment-corpectomy and reconstructed with a long titanium mesh and plate.Group Ⅱ was performed the three-level-discectomy and fused with three cages.Group Ⅲ was performed the combination with corpectomy and discectomy.The parameters included intervertebral height,JOA score.The data was compared statistically with Student s T-test or ANOVA.[Result]JOA score in all groups was improved post operation,but there was no significant difference among the three groups.The post-operation intervertebral height lose of group Ⅰ was more significant than other two groups,three cases of titanium meshs subsidence happened in group Ⅰ and one same case happened in group Ⅲ.[Conclusion]All the three surgical methods of anterior decompression and fusion can procure wonderful clinical effect,but group Ⅱ and Ⅲ were better than group Ⅰ in the stability and the maintenance of intervertebral height post operation.

To detect the effect of the aldosterone(ald) on the development of myocyte hypertrophy in SHRs, the left ventricle-heart weight ratio (LVR), the plasma concentrations and the cardiac contents of ald, the activity of cardiac MAPKs were measured in WKY rats and in SHRs either untreated and treated with spironolactone (spiron), respectively. The incorporations of 3 H-leu in incubated myocardial tissue slices were also detected in the above groups at three incubated time points of 4, 6, 8h. The results showed that the LVR, the cardiac corporations of 3 H-leu at three time points,and the activity of MAPKs were significant increases in SHRs, whereas the LVR, the corporations of 3 H-leu at each time point, the activity of MAPKs, and the levels of plasma ald were significant deceased in spiron treated SHRs. The data suggested that the combination of the local cardiac tissue ald with its receptor could induce increases in the synthesis of the myocyte proteins,leading to myocyte hypertrophy, in SHRs by activating the cardiac MAPKs.

Retrospective study was carried out in 93 cases of endometrial carcinoma admitted to our hospital since Jan. 1985 to Dec. 1994. Thirty five cases were older than 60 years, and 24 cases were younger than 50 years. All of the cases had pathological diagnosis and were staged according to FIGO. When compared with the younger group, the rate of older patients with stage Ⅰa was higher (11.4% in younger and 45.4% in older, P