OBJECTIVE:To find out the situation of antidiabetic drugs used in 47 hospitals of Shanghai and to make objective evaluation as reference for production,sale and consumption departments.METHODS:To investigate the hypoglycemic drugs used in 47 hospitals of Shanghai during the period 1998～2001 in respect to the sum of money of consumption,kinds of drugs,DDDs and DDC.RESULTS:In recent 4 years,the annual rate of growth of antidiabetic drugs were 11.98% in DDDs?6.32% in DDC and 19.05% in sum.Among the increasing ranges of antidiabetic drugs in DDDs,joint venture drugs occupied the first place,imported drugs came second,and domestic drugs got the least.CONCLUSION:Antidiabetic drug is a kind of common drug which has developmental future.

Objective To study the diagnosis and trea tm ent of urolithiasis in patients after renal transplantation. Methods 5 cases of urinary tract stone in patients after renal transplantat ion were diagnosed and treated.In 1 case,the stone was a remnant of the stone in the donor kidney,in 3 cases,the stone was secondary to a sternotic ureterocysto stomy stoma,in the other case,a stent in the urinary tract was complicated by st one formation.Surgical removal of the stone with ureter-bladder reanastomosis w as carried out for 3,in one of which ESWL has failed.Conventional nonsurgical meas ures was adopted for 2. Results The patients have been f ollowed up for 1～13 years with all the patients and the transplants surviving.I n one of the patients with nonsurgical management,the transplanted kidney has al ready survived for 13 years. Conclusions The treatment o f urinary tract stone in a transplanted kidney is similar to the conventional pr inciples,relieving the block and removal of the stone.Risk factors of uric acid stone formation should be taken care of.

AIM:To observe the effect of Jingzhui Wentong (JZWT) Capsule (Ramulus Cinnamomi,Radix et Rhizoma clematidis,Radix Puerariae Lobatae,Radix Dipsaci,etc.) on somesthetic evoked potential (SEP),behavior and pathology of rat's cervical radiculitis induced by formalin. METHODS:Experiments were carried out:(1) 60 SD rats were divided randomly into 6 groups:control,model and Jingfukang groups,the high,moderate and low dose groups of JZWT Capsule. Rats of these groups were given water,Jingfukang or JZWT Capsule respectively,and SEP was tested after operation and 14 days after drugs were given to rats. At the same time,the animal behavior was observed daily. (2) 144 SD rats were divided into the same groups and given the same drugs as before. The nerve roots were taken out for pathological observation after 4,7,14,and 21 days with drug administration. RESULTS:In each drug group,the normal SEP was obviously restored,symptoms of encroached nerve were notably lightened,inflammatory reaction and proliferation tissue of mimic cervical radiculitis were more obviously alleviated than that in the model group of rat. CONCLUSION:JZWT Capsule can reduce significantly pathology change of mimic cervical radiculitis in rats,and promote the recovery of nerve function.

Objective To investigate the effect of mechanical thrombectomy device Solitaire AB for the treatment of distal occlusion of the intracranial artery caused acute anterior circulation ischemic stroke. Methods The clinical data of 9 patients with arterial occlusion of distal anterior circulation treated by using the Solitaire AB thrombectomy device were analyzed retrospectively. Seven of them had M2 middle cerebral artery occlusion and 2 had A3 occlusion. Their clinical features,imaging data,treatment,and the results of 3-month clinical follow-up were analyzed. The effectiveness of treatment was evaluated through the recanalization rate after stent thrombectomy,the National Institutes of Health Stroke Scale (NIHSS)scores before and after treatment,the modified Rankin scale (mRS)scores,and the 3-month clinical follow-up results. The surgery-related complications and mortality of patients were used to evaluate the safety of the treatment. Results (1 )Of the 9 intracranial arterial occlusions,8 were recanalized successfully. The modified thrombolysis in cerebral infarction (mTICI)was 2b or grade 3. (2)The NIHSS score median 9. 5 (3. 0,15. 5)at discharge dropped significantly compared with 19. 0 (16. 0,22. 0)before procedure. (Z=2. 703,P=0. 007). No permanent complications related to operation occurred. Four of the recanalized patients had good prognosis (mRS 0-1)and 4 had disability (mRS 3-4 ). The mRS score of one non-recanalized patient was 4 at the 3 months follow-up. Conclusion The embolectomy effect is good whom using Solitaire AB device for acute occlusion occurred in the intracranial artery M2 or A3 segment. Its efficacy,safety,and indications still need to be further explored in a larger sample controlled trial.

Expression of platelet-derived growth factor (PDGF)-B mRNA was measured by semi-quantitative RT-PCR in renal cortex of diabetic and control Wistar rats. The expression of PDGF-B mRNA in renal cortex of diabetic rats was 2.5-fold of normal rats, suggesting that PDGF-B seems to play a role in diabetic nephro-pathy.

ObjectiveTo investigate the correlation of dysphagia and malnutrition of patients with acute stroke and to establish intervention countermeasures.MethodsThe Swallow Water Test was performed by professional rehabilitation nurses in 100 cases of acute stroke patients without food and water within 24 hours after admission and two weeks later to confirm the existence of dysphagia.Rehabilitation exercises of swallow function were performed pertinently.At the same time,we evaluate the state of nutrition of these patients and followed up for two weeks,and to determine the state of malnutrition.ResultsThere was 23.0%(23/100) acute stroke patients didn't pass the initial Swallow Water Test,19 patients (82.5%) with dysphagia could swallow normally before discharge,13% patients needed indwelling nasal-gastric tube.The rate of malnutrition in dysphagia group (34.8%) was higher than patients without dysphagia (11.7%),the difference was statistically significant (P<0.05).In addition,the activity ability of daily living was poorer,the disability degree was higher and the average day of hospitalization was longer in dysphagia group in the fourth week.ConclusionsTo estimate the dysphagia timely in acute stroke patients can make the medical staff think highly of this status to formulate the scientific project of nutrition and provide the scientific rehabilitation exercises to the patients.It can decrease the incidence rate of malnutrition,complications and the disability degree of the acute stroke patients and to promote early rehabilitation.

ObjectiveTo evaluate the efffects dexamethasone (DEX) administration at different times on intestinal ischemia-reperfusion(I/R) injury and inducible nitric oxide synthase(iNOS) activity in mice.Methods Tirty-five healthy male Kunming mice weighing 20-24 g were randomly divided into 5 groups( n =7 each): Sham operation group (group Ⅰ ); intestinal I/R group (group Ⅱ ); DEX administration before ischemia group (group Ⅲ ); DEX administration during ischemia group ( group Ⅳ) and DEX administration at the begining of reperfusion group (group Ⅴ ).Intestinal I/R injury was induced by clamping the superior mesenteric artery for 30 min.Normal saline10 mg/kg,DEX 10 mg/kg was injected iv at 30 min before ischemia in groups Ⅱ and Ⅲ respectively.DEX 10 mg/kg was injected iv at 5 min of ischemia in groupⅣ and immediately at the begining of reperfusion in group Ⅴ.The mice were sacrificed at 3 h of reperfusion,and then the small intestinal tissues were taken for determination of intestinal pathological score( Chiu score),iNOS activity and nitric oxide (NO) content.ResultsChiu score was significantly higher in groups Ⅱ - Ⅴ,and iNOS activity and NO content were sinificantly higher in groups Ⅱ,Ⅳ and Ⅴ than in group Ⅰ ( P ＜ 0.05).Chiu score,iNOS activity and NO content were sinificantly lower in group Ⅲ,and were higher in group Ⅴ than in group Ⅱ ( P ＜ 0.05).There was no significant difference in the indexes mentioned above between groups Ⅱ and Ⅳ ( P ＞ 0.05).ConclusionDEX administration before ischemia can reduce intestinal I/R injury by inhibiting iNOS activity; DEX administration during ischemia has no effcet on intestinal I/R injury and iNOS activity; DEX administration at the begining of reperfusion aggravates intestinal I/R injury by enhancing iNOS activity.

Aim To investigate whether ischemic postconditioning could induce ischemic tolerance to focal cerebral reperfusion injury and comparison with ischemic preconditioning. Methods A reversible middle cerebral artery occlusion (MCAO)was used in this study. Fifty male Sprague-dawley rats were randomized into five groups(n=10): sham-operated group,MCAO group,preconditioning group, postconditioning group and nimodipin group . The neurological function was scored and the infarct volume was measured after operation. The grouping,experimental methods and procedures of another fifty rats were as above except that ipsilateral brain of infarction was dissected and made into homogenate,then the contents of MDA,SOD,GSH and LA were quantitatively measured. Results The postconditioning and preconditioning improved the neurological function,reduced the cerebral infarction volumes and cerebral swelling significantly compared with those of the MCAO group. Contents of LA and MDA were lower, while the activity of SOD in the brain tissues were higher in preconditioning group and postconditioning group than those of the MCAO group. Conclusion Postconditioning could induce brain tolerance, and increase the antioxidant activity, which might be an important mechanism of induction of brain tolerance.

Objective To investigate the relationship between JAK2 V617F mutation and vascular embolism diseases,in order to provide important basis for clinical diagnosis and treatment and prevention of embolism.Methods Patients who were hemoglobin ＞ 160 g/L,platelets ＞ 300×109/L treated in department of neurology,heart and vascular surgery in Xuanwu Hospital of Capital Medical University were collected.Vessel embolism and JAK2 V617F mutation situation and correlation were retrospectively analyzed.Results Among the total 56 cases,JAK2 V617F gene mutation positive rate was 37.50 ％ (21/56),the incidence of embolism was 40.07 ％ (23/56),there was correlation between JAK2 V617F mutation and embolism (P =0.014).Conclusion JAK2 V617F mutation is helpful to early diagnosis and treatment of myeloproliferative neoplasm,reduce thrombosis complication,improve the quality of life.

Objective: To investigate the role of indoleamine 2, 3-dioxygenase in the development of uterine cervical squamous carcinoma. Methods: From January 2008 to December 2008, 116 uterine cervical carcinoma specimens and 18 metastatic lymph node specimens from patients with CIN Ⅰ-Ⅲ and uterine cervical squamous carcinoma were evaluated for iDO expression by immunohistochemistry. Twenty normal cervical specimens and 20 normal lymph node specimens were used as the controls. Results: The expression of IDO was not found in normal cervix and CIN Ⅰ. In CIN Ⅱ, IDO expres-sion was weakly positive in 2 cases (2/10, 20%) and negative in 8 cases (8/10, 80%). In CIN Ⅲ, IDO expression was weak-ly positive in 8 cases (8/13, 61.5%), positive in 1 case (1/13, 7.7%) and negative in 4 cases (4/13, 30.8%). The positive ex-pression rate of IDO in cervical cancer stage Ⅰ -Ⅳ was 100% (83/83). In cervical cancer stage Ⅰ A and Ⅰ B, the positive ex-pression rate of IDO was significantly higher than that in CIN Ⅱ and CIN Ⅲ (P<0.01). The positive expression rate of IDO in cervical cancer stage Ⅱ A-Ⅳ B was significantly higher than that in Ⅰ A and Ⅰ B. IDO expression was associated with cervi-cal cancer progression (OR=0.807, P<0.01). IDO expression in primary lesions with lymph node metastasis was significant-ly higher than that in those without lymph node metastasis. IDO expression rate was 100% in metastatic lymph nodes. The IDO expression was not associated with cervical squamous carcinoma differentiation degree (OR=-0.139,P>0.05). Conclu-sion: In CIN Ⅱ, escape mechanisms that stimulate cervical squamous carcinoma progression is gradually developed. IDO expression in metastatic lymph nodes is possibly associated with immune tolerance. IDO expression is not associated with differentiation degree of cervical squamous carcinoma. IDO may be a prognostic factor for uterine cervical squamous carci-noma and a therapeutic target for treatment.