Objective: To study the relationship between the activation of hepatic stellate cell(HSC) and the early stage of liver fibrosis in experimental diabetic tree shrews.Methods: Tree shrews were divided randomly into normal control group and streptozocin(STZ)-treated group.STZ-treated animals were then divided into diabetic group and STZ control group.ALT,AST,Type Ⅳ collagen(Ⅳ-C),Laminin(LN) and Hyaluronic acid(HA) were detected respectively before and after modelling.Liver biopsy was performed at the end of the experiment(8th week).All of the liver specimens were observed in light microscope and transmission electron microscope.?-smooth muscle actin(?-SMA) was detected by immunohistochemistry and computer image analysis system.Results: Early fibrosis of the liver in diabetic tree shrews can be found by both light and electron microscope.There were some ?-SMA positive HSCs,namely,activated HSCs could be observed in the liver of diabetic group but not in other two groups.The expression of ?-SMA increased significantly in the liver of diabetic group as compared with that of other two groups.In addition,the level of expression of ?-SMA was positively correlated with the collagen area density in diabetic group.Conclusion HSC may play an important role in the development and aggravation of liver fibrosis in diabetic tree shrews.

Objective To investigate the efficacy of intermittent epidural bolus ( IEB) for patient?controlled epidural analgesia ( PCEA) during delivery. Methods Eighty?five parturients requesting epi?dural analgesia, who were at full term ( 37-42 weeks of gestation) with a singleton fetus in vertex presenta?tion, of American Society of Anesthesiologists physical statusⅠorⅡ, with body mass index< 35 kg∕m2 , were divided into either IEB group ( n=42) or continuous epidural infusion ( CEI) group ( n=43) using a random number table. The analgesia solution contained 0.08% ropivacaine and 0.4μg∕ml sufentanil in both groups . IEB settings were a 6 ml bolus every hour at the rate of 400 ml∕h with a bolus dose 6 ml and lockout interval 30 min. CEI settings were background infusion 6 ml∕h with a bolus dose 6 ml and lockout interval 30 min. Numeric rating scale score was maintained≤5, and if the efficacy was not satisfactory, a bolus of pump solution 5-10 ml was added. The consumption of analgesics per hour, initial PCA time, and occur?rence of lower extremity numbness, motor block, nausea and vomiting, and pruritus were recorded. Pa?tients′satisfaction with analgesia was scored, and the duration of labor and mode of delivery were recorded. Results Compared with group CEI, the initial PCA time was significantly prolonged, the satisfaction score was significantly increased, the incidence of lower extremity numbness was significantly decreased ( P<0.05) , and no significant change was found in the consumption of analgesics per hour, incidence of motor block, nausea and vomiting, and pruritus, constituent ratio of mode of delivery, and duration of la?bor in group IEB ( P>0.05) . Conclusion IEB can be safely and effectively used for PCEA during deliver?y, and the efficacy is better than that of CEI in the parturients.

Objectives To investigate the relationship between the insertion and deletion (I/D) polymorphism of human angiotensin converting enzyme (ACE) gene and the vascular complications in type 2 diabetes. Methods The I/D polymorphism of ACE gene was detected by polymerase chain reaction in 120 type 2 diabetic patients and 100 healthy controls. Results The frequency of DD genotype was significantly higher, while frequency of II genotype was lower in diabetic nephropathy patients (DN) than those in control group. The frequency of ID genotype was significantly higher, while frequency of II genotype was lower in type 2 diabetic patients with coronary heart disease (CHD), when compared to those without CHD. The frequencies of ACE genotypes in patients with diabetic retinopathy (DR) or hypertension (HP) were not different from those in control group and non-DR or non- HP patients. Conclusions ① There were relationships between the I/D polymorphism of ACE gene and DN and CHD in type 2 diabetes. ② The DD genotype and D allele of ACE gene might be as markers in predisposing DN, while II genotype and I allele as protective factors for DN in diabetes. The ID genotype might be as a marker in predisposing CHD, while II genotype as a protective factor for CHD in diabetes.③ There was no relationship between I/D polymorphism of ACE gene and HP or DR in diabetes in Guangxi region.

Objective To establish an RP-HPLC method for determining serum level of valproate.Methods A symmetryshield RP18 column (5?m,3.9mm?150mm) was used.The mobile phase,methanol-water(80:20) was used at a flow rate of 1.0ml/min.The detector was Waters 2487 dual?absorbance detector,which was set at the wavelength of 248nm.Serum sample was extracted with 2ml acetic n-hexane,then valproic acid in organic layer was derived by adding into?-bromoacetophenone,and cyclohcxanecarboxyiic acid was selected as an internal stan- dard.Results The calibration curve was linear in the range of 5.0 to 250.0vtg/ml.The average recovery rate was 98.23%,and the RSD within-day and between-day were both less than 3 %.Conclusion This method is suitable for therapeutic drug monitoring of phenytoin.

OBJECTIVE: To observe the effect and safety of exenatide therapy in type 2 diabetes patients with failure to metformin. METHODS: Sixty patients with type 2 diabetes who did not achieve satisfactory blood glucose control were randomly assigned either to add exenatide or glargine. postprandial blood glucose, HbA1C, blood lipid, and body mass index of the patients before and after treatment were recorded, and the side effects were also recorded for 52 weeks. RESULTS: The FPG and HbA1C of patients decreased more significantly after exenatide therapy than glargine treatment (P<0.05). The exenatide group had a significantly higher level of ΔHOMA-13 than the glargine group. CONCLUSION: Exenatide can be used for long-term control of blood glucose with improving lipid metabolism and low occurrence of hypoglycemia, without increasing body weight.

The internship is the transition period of a medico becoming a doctor,the cultivation of clinical work ability of interns is a comprehensive ability cultivation which includes the foundation theories' consolidation and use,the practical operative train- ing,the cultivation of clinical thought ability and communication between doctors and patients,etc.To educate pediatrics intern has its characteristics.

Objective To evaluate the effects of different storage periods at room temperature on domestic cisatracurium-induced neuromuscular (N-M) block.Methods One hundred and twenty ASA Ⅰ or Ⅱ patients,aged 18-64 yr,scheduled for elective operations under general anesthesia,were randomly divided into 3 groups (n =40 each):cisatracurium stored for 60 days at 4-8 ℃ group (group LT),cisatracurium stored for 30 days at room temperature group (group RT30) and cisatracurium stored for 60 days at room temperature group (group RT60).Anesthesia was induced with iv injection of midazolam and target-controlled infusion of propofol (target plasma concentration 3 μg/ml) and remifentanil (target effect-site concentration 3-5 ng/ml).A bolus of cisatracurium 0.2 mg/kg was given intravenously over 5-10 s as soon as the patients lost consciousness.N-M block was monitored with TOF-Watch SX (Organon,Netherlands).Single stimulation was applied to the ulnar nerve at wrist.The maximal degree of N-M block,onset time,clinical duration,recovery index and 75 ％ recovery time were recorded.The patients were intubated and mechanically ventilated when N-M block reached the maximal degree.The intubation condition was evaluated.Hypotension,bradycardia and skin allergy were recoded.Results Compared with group LT,no significant change was found in the onset time,clinical duration,recovery index and 75％ recovery time in group RT30 (P ＞ 0.05),and the onset time was significantly prolonged,clinical duration and 75％ recovery time were shortened in group RT60 (P ＜ 0.05).The onset time was significantly longer and clinical duration was shorter in group RT60 than in group RT30 (P ＜ 0.05).The intubation condition was excellent or good in the three groups and there was no significant difference among the three groups.There was no significant difference in the incidence of hypotension and bradycardia among the three groups (P ＞ 0.05).No patients developed skin allergy.The maximal degree of N-M block was 100％ in groups LT,RT30 and RT60 except one case with 95％ in group RT60.Conclusion No significant change is found in the N-M block induced by domestic cistracurium when stored for 30 days at room temperature,however,the N-M block is significantly attenuated when stored for 60 days at room temperature.

Objective To investigate the effect of the evaluation on teaching hospitals affiliat-ed to medical colleges in Guangdong province. Methods Questionnaire and on on-the-spot investi-gation was conducted among 18 teaching hospitals which owned the accreditation for 2-3 years based on Guangdong provincial teaching hospital accreditation indicator system 2008 modified version. Contents of investigation included general situation,teaching condition,management and implementa-tion of teaching activities as well as medical staffs' comments and suggestions for the teaching work. SPSS 13.0 software was used for frequency analysis. Results The general situation,teaching condi-tion,management and implementation of teaching activities were improved to varying degrees after the evaluation according to results of the questionnaire. 90.0%(54/90)people thought that the overall scale of the hospital was expanded and 5.0%(3/60)people thought that the overall scale of the hos-pital was obviously reduced or marinated the original level. 11.6%(7/60)and 88.3%(53/60)people thought that medical quality of the hospital was improved or obviously improved. 60.0%(36/60)people thought that educational occupancy of the hospital was improved while 5.0%(3/60)people thought that it was unsatisfactory. 83.3%(50/60)people thought that teaching mold and infrastructures were improved while 10.0%(6/60)people thought that it was unsatisfactory. 95.0%(57/60)people thought that teaching management was improved. Due to the lack of incentives and support in teaching work, management of teaching was loose. Conclusions The teaching work of t hospitals affiliated to medical colleges in Guangdong province do persevere basically and achieve desired purposes.

Objective To determine the contents of scutellarin and chlorogenic acid in Qingkailing extract by HPLC.Methods Kromasil C18 column was adopted and the mobile phase consisted of methnol-water-phosphoric acid (20 ∶80 ∶0.2) with the flow rate being 1.0 mL?min-1 and column temperature being 25 ℃.The detection wavelength was 327 nm.Results The linearity of scutellarin was good in the range of 0.090～0.540 ?g,r=0.999 9,and its average recovery rate was 100.3 %(RSD=0.99 %);the linearity of chlorogenic acid was good in the range of 0.196～1.176 ?g,r=0.999 9,and its average recovery rate was 99.9 %(RSD=1.06 %).Conclusion This method is sensitive,simple,accurate,and can be used for the quality control of Qingkailing extract.

Adult ; Aged ; Dust ; analysis ; Humans ; Middle Aged ; Niacin ; therapeutic use ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; Occupational Exposure ; analysis ; prevention & control ; Silicon Dioxide ; adverse effects