Shuyu Pill is the representative prescription for treating deficiency-essence. This article discussed the consistency of diabetes and deficiency-essence from TCM syndromes and etiology and pathogenesis, and probed into the correlation between Shuyu Pill and diabetic Western medicine of pathomechanism diabetes from the modern pharmacological research on Shuyu Pill. Therefore, it proposed that diabetes has the essence of deficiency-essence;the pathogenesis of diabetes should meet the efficacy of Shuyu Pill; pharmacological effects of Shuyu Pill can affect various pathological mechanism of diabetes, with a purpose to provide new ideas for the clinical treatment of diabetes.

AIM:To explore whether A3 adenosine receptor plays a role in the modulation of vascular reactivity after hemorrhagic shock in rat,and to find out the prospective drug target to restore the decreased vascular reactivity following hemorrhagic shock. METHODS:The hemorrhagic shock (40 mmHg) model was established in rat,and the reactivity of superior mesenteric artery (SMA) to norepinephrine (NE) was observed. A3AR expression at protein level and mRNA level were measured by Western blotting and RT-PCR respectively. RESULTS:The vascular reactivity of SMA to NE after hemorrhagic shock (40 mmHg) was decreased significantly in a biphasic response manner. The expression of A3AR mRNA in SMA after hemorrhagic shock decreased without significant difference. The expression of A3AR protein has a slight increase without statistical difference after 30 min of hemorrhagic shock and then has a significant decrease (especially at 2 h and 4 h after hemorrhagic shock). The usage of IB-MECA,a selective A3AR agonist,significantly increased the responsiveness of SMA to NE in hemorrhagic shock in rat. MRS1523,the selective A3AR antagonist,significantly abolished the restoration of the vascular reactivity to NE by IB-MECA in hemorrhagic shock in rat. CONCLUSION:A3AR plays a role in the modulation of vascular responsiveness to NE in hemorrhagic shock in rat,and the selective agonist of A3AR could restore the reactivity of SMA to NE in hemorrhagic shock in rat.

Objective: To evaluate the clinical efficacy of sinew-regulating bone-setting manipulations plus exercise therapy in treating chronic non-specific low back pain (CNLBP). Methods: A total of 65 CNLBP patients were divided into two groups by the random number table method. Thirty-three cases in the treatment group were intervened by sinew-regulating bone-setting manipulations plus exercise therapy; 32 cases in the control group were intervened by medium-frequency electrotherapy plus exercise therapy. Before and after treatment, visual analog scale (VAS), dynamic and static muscle endurance of low back, median frequency (MF) of surface electromyography (sEMG) and Oswestry disability index (ODI) were used to evaluate the low back function. The therapeutic efficacy was estimated after treatment. Results: The two groups each had 2 dropouts during the study. The total effective rate was 90.3％ in the treatment group versus 66.7％ in the control group, and the between-group difference was statistically significant (P<0.05). After treatment, the VAS score, dynamic and static muscle endurance of low back, MF of sEMG and ODI score all changed significantly in both groups (all P<0.05); all the items in the treatment group were significantly different from those in the control group (all P<0.05). Conclusion: Sinew-regulating bone-setting manipulations plus exercise therapy can effectively release pain in CNLBP patients, increase muscle endurance of the low back and improve the quality of life, and its therapeutic efficacy is more significant than that of medium-frequency electrotherapy plus exercise therapy.

Diagnostic whole body scan (Dx-WBS) with 131I and serum Tg level are the main parameters to evaluate the effectiveness of thyroid remnant ablation in patients with DTC.Undetectable Tg and positive radioiodine uptake in the thyroid bed (Tg-/Dx-WBS+) may be found in some patients.However,the clinical significance is uncertain.A small amount of thyroidal remnant,a small DTC lesion,increased expression of NIS gene and autoimmune inflammation may all result in Tg-/Dx-WBS+.A wait-and-watch approach without rushing for high-dose radioiodine treatment might be a more reasonable approach for these patients.

Objective: To observe the effect of electroacupuncture (EA) pretreatment on the protein expression of c-fos in fastigial nucleus (FN) and lateral hypothalamus area (LHA) in rats with acute myocardial ischemia-reperfusion injury (MIRI), and to explore the role and mechanism of FN and LHA in EA at the Heart Meridian fighting against acute MIRI reaction. Methods: Seventy Sprague-Dawley rats were randomly divided into a sham operation group, a model group, an EA-Heart Meridian group and an EA-Lung Meridian group, with 14 rats in each group; an LHA lesion plus EA-Heart Meridian group (LHA+EA-Heart Meridian group) and a FN lesion plus EA-Heart Meridian group (FN+EA-Heart Meridian group), with 7 rats in each group. Except the sham operation group, the left anterior descending branch of coronary artery was ligated to establish acute MIRI rat models in the other 5 groups. In the three groups with EA-Heart Meridian treatment, Shenmen (HT 7) and Tongli (HT 5) were selected; Taiyuan (LU 9) and Lieque (LU 7) were selected in the EA-Lung Meridian group. All the EA groups received EA stimulation prior to modeling, with 1 mA in current intensity and 2 Hz in frequency, 20 min each time, once a day for a total of 7 d. The sham operation group and the model group did not receive EA stimulation. The electrocardiogram was observed in the rats to analyze the ST-segment deviation and cardiac arrhythmia score. The expression of c-fos protein in FN and LHA was detected by immunohistochemistry method. Results: Compared with the sham operation group, the ST-segment deviation, cardiac arrhythmia score and the expression of c-fos protein in the FN and LHA increased significantly in the model group (all P<0.05). Compared with the model group, the ST-segment deviation, cardiac arrhythmia score and the expression of c-fos protein in FN and LHA decreased significantly in the EA-Heart Meridian group (all P<0.05). Compared with the EA-Heart Meridian group, the ST-segment deviation and cardiac arrhythmia score increased significantly in the EA-Lung Meridian group, LHA+EA-Heart Meridian group and FN+EA-Heart Meridian group (all P<0.05); the expression of c-fos in FN increased significantly in the EA-Lung Meridian group and LHA+EA-Heart Meridian group (both P<0.05); the expression of c-fos in LHA increased significantly in the EA-Lung Meridian group and FN+EA-Heart Meridian group (both P<0.05). Conclusion: FN and LHA are involved in the mechanism of EA at Heart Meridian to improve the acute MIRI reactions, and the cerebellum may participate in the improvement of cardiac function by EA through the cerebellum-hypothalamus projection.

Objective: To observe the therapeutic effect of sinew-regulating bone-setting manipulations for knee osteoarthritis (KOA) model rabbits and its impacts on the chondrocyte apoptosis rate and the levels of interleukin (IL)-1β and nitric oxide (NO). Methods: According to the random number table method, 30 New Zealand white rabbits were divided into a normal group (n=9) and a modeling group (n=21). Rabbits in the modeling group were used to establish KOA models with the modified Hulth method. At the 8th week, three rabbits were sacrificed to verify the model and the remaining 18 rabbits were randomly divided into a model group (n=9) and an intervention group (n=9). Rabbits in the normal group and model group were bred routinely without any intervention. Rabbits in the intervention group were treated with the sinew-regulating bone-setting manipulations, 10 min/time, once every other day for a total of 20 times. The Lequesne MG knee function rating was used to evaluate the behavioral differences of the rabbits in each group. The Pelletier score was used to evaluate the general changes of the rabbits. The Mankin score was used to evaluate the pathology of knee cartilages. The enzyme-linked immunosorbent assay and nitrate reductase methods were used to determine the levels of IL-1β and NO in serum and synovial fluid of each group, respectively. In situ terminal deoxynucleotidyl transferase-mediated nick and labeling method was used to determine the apoptosis of chondrocytes in each group. Results: Compared with the normal group, the scores of Lequesne MG, Pelletier and Mankin, and the levels of IL-1β and NO in the model group were increased (P<0.05), which indirectly indicated the success of the model. Compared with the model group, the scores of Lequesne MG, Pelletier and Mankin, IL-1β and NO levels, and chondrocyte apoptosis rate of the intervention group were decreased, and the differences were statistically significant (P<0.05). Conclusion: The sinew-regulating bone-setting manipulations can reduce the levels of IL-1β, NO, and chondrocyte apoptosis rate, and delay the articular cartilage degeneration, therefore, having a good therapeutic effect on KOA.

Objective: To explore the distribution features of microvolt T-wave alternation(MTWA) through exercise stress test (EST) in coronary artery disease (CAD) patients with MTWA changes after revascularization. Methods: MTWA was measured in pre-cordial ECG leads in 326 patients with suspected CAD. Based on coronary angiography and coronary CTA, the patients were divided into 4 groups: ① Control group, patients without coronary stenosis, n=101, ② Coronary stenosis<50％ group, n=99, ③ 50％ ≤ Coronary stenosis<70％ group, n=53 and ④ Coronary stenosis ≥ 70％ group, n=73; MTWA was compared among different groups. 95 patients with coronary stenosis ≥ 50％were further divided into 2 subgroups: R (right coronary)stenosis ≥ 50％ subgroup, n=23 and LAD (left anterior descending branch) stenosis ≥ 50％ subgroup, n=72; MTWA was respectively compared to Control group. In addition, MTWA was collected from 103 patients with percutaneous coronary intervention (PCI) as PCI group, MTWA was compared to Coronary stenosis ≥ 70％ group. Results: MTWA was obviously higher in Coronary stenosis ≥ 70％ group than the other 3 groups, all P<0.01. Compared with Control group, Rstenosis ≥ 50％ subgroup had increased MTWA in V4-V6 pre-cordial leads, P<0.05; LAD stenosis≥50％ subgroup had increased MTWA in V1-V2 pre-cordial leads, P<0.01. Compared with Coronary stenosis ≥ 70％group, PCI group showed reduced MTWA, P<0.01. Conclusion: CAD patients with severe coronary stenosis (≥70％) had increased MTWA; MTWA distribution in body surface was approximately corresponding to coronary stenosis site and PCI may decrease MTWA in CAD patients.

Objective To discuss the method,mid-long term clinical therapeutic effect and safety of coil embolization in treating patients with hepatic arterial pseudoaneurysm(HAPA).Methods Seven patients with repeatedly massive hemorrhage of gastrointestinal tract were undertaken DSA of celiac arteries and hepatic arteries and embolization of the feeding artery by coils or microcoils after correct diagnosis.All cases underwent follow-up from 6 to 60 months(mean 38).Results The blood loss before angiography was ranged from 1200 to 4000(mean 2385)ml.There were 3 cases with normal hepatic function and 4 with hepatic dysfunction including ALT increase in 2 and obstructive jaundice in another.Digital substraction angiography(DSA)clearly showed the location,shape and feeding arteries of HAPA.There were 2 types of HAPA namely intrahepatic (n=3)and extrahepatic(n=4),adding one case with arteriovenous fistula(AVF).Embolization was successful in all cases by coils(n=13)or microeoils(n=12).No recurrence and any definite clinical complication occurred during follow-up.Conclusion Coil embolization in treating HAPA is safe and effective with mid-long term positive clinical therapeutic efficiency without severe complications.(J Intervent Radiol, 2007,16:803-806)

Objective To investigate the expression of metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in endometriosis (EMS) and its diagnostic value.Methods The information of EMS gene expression was collected from Gene-Cloud of Biotechnology Information (GCBI) and analyzed,in which MALAT1 gene was screened out accordingly.The total RNAs were extracted from tissues and serum samples of the patients with ovarian endometriosis and non-endometriosis and the expression of MALAT1 was detected by real-time quantitative PCR.The correlation between MALAT1 expression level and menstrual cycle was analyzed.The differential diagnostic efficacy of serum MALAT1 levels was analyzed by receiver operating characteristic (ROC) curve.Results Compared with the non-EMS group the expression of MAL4T1 gene was down-regulated by 1.35-fold (t =-3.27,P ＜ 0.01) in EMS group according to gene information analysis of GCBI.The relative expression levels of MALAT1 in ectopic and eutopic endometrium of patients with ovary endometriosis (0.41 ±0.18 and 0.61 ± 0.12) were significantly lower than those in non-endometriosis patients (1.05 ±-0.34,t =5.87 and 4.48,P ＜ 0.01).However,the expression level of MALAT1 was not related with menstrual cycle of the patients with ovarian endometriosis and non-endometriosis (t =1.54 and 1.52,P ＞ 0.05).The expression of MALAT1 in ectopic ovarian cysts was significantly lower than that in eutopic endometrium of ovary endometriosis (t =3.77,P ＜ 0.01).The relative expression of serum MALAT1 in ovary endometriosis (0.60 ±0.18) was significantly lower than that in non-endometriosis (1.05 ± 0.32,t =5.18,P ＜ 0.01).The area under the curve (AUCsOc) was 0.88.When the cut-off value of serum MALAT1 level was set as 0.74,the sensitivity and specificity of expression level of MALAT1 were 82.4％ and 92％ respectively,and Youden's index was 74.4％.Conclusion Low expression of MALAT1 in endometriosis may be related with occurrence and development of endometriosis.Serum MALAT1 level may have certain differential diagnostic value for EMS.

Objective To improve the classic Vannucci method for establishing a model of hypoxic-ischemic brain damage in the neonatal mice. Methods Postnatal day 11 KM mice were randomly assigned into normal control group ( N group, n=20) and hypoxic-ischemic brain damage group (HIBD group, n=160). For the HIBD group, the left common carotid artery of mice was ligated and exposed to hypoxia according to different conditions in the groups C1-C8, then com-pared the mortality and the success rates of all groups. TTC staining and relative infarct volume was measured to select the most stable conditions of modeling. In all groups, the growth and development of mice were evaluated by body weight growth curve at different time points after modeling. Longa test, grip test and hanging test were porformed to assess the neu-romotor function. HE staining was used to detect cerebral neuronal pathological changes. Results Neonatal mouse models of hypoxic-ischemic brain damage were established by the left common carotid artery ligation and hypoxia for 45 min under conditions of 8% O2 and 35℃, which resulted a low mortality rate (8. 3%) and high success rate (47. 92%). Compared with the normal group, mice of the HIBD group grew slowly in body weight and showed severe motor dysfunction. The liga-tion side of cerebral artery showed infarction area which accounted for 7. 76 ± 0. 70% of the total brain. The cortex and hip-pocampus of ligated brain tissue showed neuron degeneration and necrosis. Conclusions The neonatal mouse model of hy-poxic-ischemic brain damage is successfully established by our modified method , i. e. to ligate the left common carotid ar-tery and to expose the mice to hypoxia at 8% O2 and 35℃ for 45 min. This model provides a liable and stable experimental animal model for research of neonatal hypoxic-ischemic brain damage.