Objective To investigate the molecular mechanism of metformin. Methods The changes of protein expression of IRS-1 in liver, skeletal muscle and adipose tissues after treatment with metformin for OLETF rats, a model of spontaneous type 2 diabetes mellitus, were measured by Western blot analysis, and compared with those before treatment. Results 22 weeks after the treatment with metformin, the protein expression of IRS-1 was significantly increased in liver (P0. 05) ;and the protein expression of IRS-1 in adipose tissue was significantly decreased (P

Objective To investigate the effects of transfection of chemokine receptor CXCR4 antisense-RNA on the functional expression of VEGF-C mRNA and the invasive ability of colon cell line HT-29 in vitro.Methods PCR primers were designed according to the coding sequence of CXCR4 gene.EcoR Ⅰ and BamH Ⅰ recognition sequences and cutting sites were added to the 5' end of the antisense primer.The purified PCR fragment was retro-inserted into the cloning site of eukaryotic expression vector pcDNA3.1(+).The pcDNA3.1(+)for CXCR4 antisense-RNA was transfected into colon cancer HT-29 cells by liposome transfection.The expression of VEGF-C mRNA was detected by RT-PCR.The expression of CXCR4 protein was determined by Western blot.At the same time,cell growth kinetics was assessed by MTT assay,and in vitro invasive ability was assessed with Boyden chamber.Results CXCR4 antisense-RNA recombinant was successfully constructed.The expression of VEGF-C mRNA in antisense-CXCR4 transfected(HT-29tran)group decreased by 54.2%,while the expression of VEGF-C mRNA in vacant-transfected(HT-29KZ)group only decreased by 9.4% campared with non-transfected(HT-29)group.The difference between the two groups mentioned above was remarkable(P

Objective To study the influence of unilateral and bilateral amplification on the effect of hearing aid evaluation .Methods Using the subjective method that International Outcome Inventory for Hearing Aids (IOI-HA) and objective method that medium acoustic intensity (65 dB SPL) word recognition score(WRS) to evaluate the effect of unilateral and bilateral hearing aid fitting of middle -aged severe sensorneural hearing loss .Results Hearing aid were used for severe sensorneural hearing loss and the improvement of monosyllables and sentences in quiet and noise test of unilateral were 35 .73% ,43 .15% ,43 .23% ;the improvement of monosyllables and sentences in quiet and noise test of bilateral were 37 .90% ,51 .33% ,54 .86% .The WRS of bilateral was higher than unilater-al .The score of IOI-HA was 15~37 ,meaning patients with severe sensorneural hearing loss were satisfied with hearing aid ,and there was no statistical significance between unilateral and bilateral fitting .Conclusion The bilat-eral hearing aid fitting was better than unilateral .Binaural hearing loss are recommended to fit bilaleral hearing aids .

OBJECTIVE： To confirm the efficacy and safety of latanoprost in treating glaucoma.METHODS： In a double blind， randomized control clinical trial， we compared the efficacy and adverse drug reactions of once daily topically applied 0.005％ latanoprost with those of twice daily 0.5％ timolol for 12 weeks in patients with open angle glaucoma or ocular hypertension.RESULTS： The study included 46 patients（22 pts.randomized to latanoprost treatment， 24 pts.to timolol） ， 46 patients remained at the end of the study.Comparing with baseline diurnal intraocular pressure（IOP） ， the IOP reduction（mean±standard deviation） achieved with latanoprost（7.86±2.39） mmHg， （31.1％， P<0.001），and timolol（6.24±2.58）mmHg （24.9%，P<0.001），the difference between the two groups（1.62mmHg） being significant（P<0.01）. Two patients treated with latanoprost had foreign body sensation. No other ocular and systemic adverse reactions related to the two drugs were found. CONCLUSION: The results of this study demonstrated that 0.005% latanoprost applied once daily is well tolerated and more effective in reducing IOP than 0.5% timolol applied twice daily. Thus, latanoprost has the potential for becoming one of the ideal antiglaucoma drugs.

By means of literature review,expert interviews and experts sorting,the authors identified three approaches of medical humanities care,and applied them to three clinical departments of top ten incidence of medical disputes of the hospital in 2012.These departments have similar number of beds,and covered both internal medicine and surgery departments.The purposes of the study are to evaluate the effects of medical humanities care measures in clinical departments,and to make relevant thoughts and suggestions.

Using the method of semi -structure interviews to pre-interview 6 experts and officially interview10 experts , then the record of the interview was compiled into the paper .Using the grounded theory method to encode material of the interview , a summary was made for each case base on data collation and analysis .This paper ana-lyzed the humanities concern the connotation of the application in the construction of a harmonious doctor -patient relationship and the specific measures .On the basis of the application of humanistic care in the construction of a harmonious doctor -patient relationship , significance and limitation is discussed .

This study was aimed to simultaneously determinate the content of naringin, hesperidin and atractylodin in Y un-Pi (YP) Powder extract by HPLC. A Thermo ODS-2 column (250 mm í 4.6 mm, 5 μm) was used for the gra-dient elution with a methanol-water of 0~5 min (30%~40% A), 5~15 min (40%~50% A), 15~20 min (50%~79%A), 20~30 min (79%~100% A), 30~45 min (100% A), 45~55 min (100%~30% A), 55~60 min (30% A). The col-umn temperature was at 30℃. The detection wavelength was at 283 nm. The flow rate was 1 mL·min-1. The linear range was determined to be 0.009 16~0.137 00 μg (r = 0.999 9), 0.006 22~0.091 30 μg (r = 0.999 8), 0.003 58~0.053 70 μg (r = 0.999 9), respectively for naringin, hesperidin and atractylodin. The average recovery rate of pterodontic acid was 103.51%, 96.82% and 97.65%. And RSD was 1.37%, 1.41%, 1.49% (n = 6). It was concluded that the method had good specificity and repeatability. It was considered as a good tool for the content determination of naringin, hesperidin and atractylodin in YP Powder extract.

Objective To study the effects of different hypoxic training modes on the activities of respiratory chain complexes in the brain mitochondria of rats. Methods Forty healthy two-month-old male Wister rats were randomly divided into 5 groups: living low-training low(LoLo), living high-training high(HiHi), living high-training low (HiLo), living low-training high(LoHi), and living high-exercise high-training low(HiHiLo). Rats were forced to complete a 5-week endurance training program. All training sessions were performed at the same relative intensity under normoxic(P=632mmHg, simulating about 1500m altitude) or hypoxic conditions(P=493mmHg, simulating 3500m altitude) for each of the five groups, respectively. Mitochondria were isolated with differential centrifugation. Spectrophotometric analysis was applied to evaluate RCC (Ⅰ- Ⅲ) activities in brain mitochondria. Results Compared with the LoLo, brain RCC activities in C Ⅱ in rats from LoHi significantly decrease(P<0.05). Brain RCC activities in C Ⅲ in rats from HiHi, HiLo and LoHi significantly decrease and from HiHiLo significantly increase (P<0.01). Conclusion These findings suggest that among different altitude training modes, HiHiLo is the superior one in developing function of mitochondria respiratory chain of rat brain tissues.

Objective To investigate the expression of Krüppel-like factor 4 (KLF4) protein in esophageal squamous cell carcinoma (ESCC) tissues and to explore its correlation with clinical pathological features as well as prognosis.Methods The expression of KLF4 protein in cancer tissues and normal esophageal tissues from surgical paraffin specimens of 98 thoracic ESCC cases with complete clinical,pathological and follow-up date were detected by immunohistochemistry.The expression of KLF4 at protein level in 20 freshly surgical esophageal cancer tissues and normal esophageal mucous tissues were examined by Western blot.The relation between the expression of KLF4 protein,clinicopathological characteristics and prognosis was analyzed,t-test was used for measurement data analysis.Chi-square test was performed to analyze the correlation between KLF4 protein expression and clinicopathological features.Survival analysis was analyzed by the Kaplan-Meier method.The comparisons of survival rates were analyzed by Log-rank test.Results The positive rate of KLF4 protein expression in normal esophageal tissues and ESCC tissues was 82.7％ (81/98) and 43.9％ (43/98),respectively,the difference was statistically significant (x2=31.701,P＜0.01).The expression of KLF4 at protein level in 20 cases of fresh esophageal cancer tissues and normal esophageal mucosa tissues was 0.576±0.050 and 0.684 ± 0.095,respectively,the difference was statistically significant (t =4.932,P＜0.01).The expression of KLF4 at protein level was correlated with lymph node metastasis and TNM stage (x2 =10.871 and 6.482,P=0.001 and 0.039),however not correlated with gender,age,location,tumor size,degree of differentiation and the depth of invasion (x2=0.214,3.442,5.748,0.891,0.013 and 1.479,P=0.644,0.064,0.056,0.345,0.911 and 0.477).In 98 patients,the 5-year survival rate of cases with KLF4 protein positive expression and negative expression was 48.8％ and 25.5％ and the median survival period was 55 months and 26 months,the differences were statistically significant (x2 =5.747 and 4.493,P=0.017 and 0.034).Conclusion KLF4 as a tumor suppressor gene may play an important role in the genesis,development and metastasis of ESCC,and may become a biological indicator of the severity and prognosis in ESCC.

Objective To investigate the correlation between different clinicopathological factors and the recurrence and metastasis of advanced adenocarcinoma of the esophagogastric junction after curative resection,and to analyze the effects of the factors on the prognosis of these patients.Methods The clinical data of 385 patients with advanced adenocarcinoma of the esophagogastric junction who received curative resection at the Affiliated Hospital of Tianjin Medical University from January 2000 to January 2007 were retrospectively analyzed.There were 228 patients did not have tumor recurrence and metastasis (non-recurrence and metastasis group) and 157 patients had tumor recurrence and metastasis (recurrence and metastasis group).Risk factors which might influence postoperative recurrence and metastasis were analyzed using univariate analysis (chi-square test) and multivariate analysis (Logistic regression model).All patients were followed up via out-patient examination or phone call.The survival curve was drawn by Kaplan-Meier method,and the survival analysis was done by Log-rank test.Results The median time for follow-up was 36 months (range,3-108 months).A total of 157 patients had postoperative tumor recurrence and metastasis,and the mean time of tumor recurrence was 17.9 mouths.The results of univariate analysis showed that tumor type,differentiation degree,invasion depth,number of positive and negative lymph nodes,TNM staging were risk factors for the postoperative recurrence and metastasis of adenocarcinoma of the esophagogastric junction after curative resection (x2=5.248,13.493,12.319,18.315,9.704,10.281,P ＜ 0.05).The results of multivariate analysis showed that differentiation degree,invasion depth,number of positive and negative lymph nodes were the independent risk factors influencing the recurrence and metastasis of adenocarcinoma of the esophagogastric junction after curative resection (OR =1.805,1.809,1.520,0.763,P ＜0.05).The numbers of positive lymph nodes in the non-recurrence and metastasis group and the recurrence and metastasis group were 3.86 ± 0.28 and 6.89 ± 0.58,with a significant difference (t =5.118,P ＜ 0.05).The number of negative lymph nodes in the non-recurrence and metastasis group and the recurrence and metastasis group were 14.04 ±0.54 and 10.53 ±0.56,with a significant difference between the 2 groups (t =4.386,P ＜0.05).The 5-year survival rates of patients with the numbers of positive lymph nodes of 0,1-2,3-6 and more than 7 were 46.4％,43.8％,27.1％ and 7.2％,respectively,and the corresponding median survival time were 53,47,35 and 26 months.There was a significant difference in the 5-year survival rate among patients with different numbers of positive lymph nodes (x2 =54.783,P ＜ 0.05).The 5-year survival rates of patients with the number of negative lymph nodes under 9,between 10 and 15 and more than 16 were 22.1％,21.5％ and 45.5％,respectively,and the corresponding median survival time were 28,34,47 months.There was a significant difference in the 5-year survival rate among patients with different numbers of negative lymph nodes (x2=22.814,P ＜ 0.05).Conclusions Tumor type,invasion depth,number of positive and negative lymph nodes are independent risk factors of postoperative recurrence and metastasis of adenocarcinoma of the esophagogastric junction,and the number of positive and negative lymph nodes are important for the prognosis of patients with adenocarcinoma of the esophagogastric junction.