Hepatic fibrosis is a wound healing response to liver injury. Activated hepatic cell is thekey evidence in the pathological fibrosis,which results in synthesis of large quantities of extracellular matrix components. Cytokines secreted mostly by activated Kupffer cell were remarkabe factors which have been proposed to stimulate and inhibit the fibrosis process.The close relationship between hepatic fibrosis and cytokines has been investigated. The article summarizes some important cytokines and the cytokines which can be used as target of antifibrotic therapy.

Objective To evaluate the clinical efficacy of tigecycline combinated with isepamicin for treatment of pneumonia caused by multidrug-resistant Acinetobacter baumannii.Methods A retrospective analysis was performed in adult patients with multidrug-resistant Acinetobacter baumannii pneumonia in two general hospitals from January 2012 to January 2014.Total eighty-four patients with MDR-Acinetobacter baumannii pneumonia were randomly divided into two groups(n=42).One group was treated with tigecycline combinated with isepamicin(termed combination therapy group),and another group was administrated with cefoperazone sulbactam (termed control group ).The clinical cure rates,microbiological eradication rates and adverse events were collected and compared. Results There was no difference in APACHEⅡ score between two groups.The clinical cure rates in combination therapy group was significantly higher than that in control group(88% vs 61%,P<0.05),and with a higher rate of microbiological eradication(59.5% vs 35.7%,P <0.05 ).However,the occurence rate of adverse events was similar in the two groups (7.1% vs 1 1.9%). Conclusion With a higher rate of clinical efficacy and a lower rate of adverse events,the combination therapy with tigecycline and isepamicin would be a promising alternative for treatment with MDR-Acinetobacter baumannii pneumonia.

Objective To study the current status of clinical control of outpatients with type 2 diabetes mellitus,and to discuss the factors influencing on disease control. Methods According to the clinical targets recommended by Asian-Pacific Type 2 Diabetes Policy Group,we calculated the success rates of blood glucose,lipid profile,blood pressure and body mass index(BMI) of patients who hospitalized in our department for more than one year(group A,n=7 356), and compared these results with the corresponding rates calculated based on the earlier database(group B,n=1 084).The success rates of metabolic indexes of patients who insisted on hospitalizing monthly(group C,(n=1 367))were calculated.Besides,the factors influencing disease control were discussed through questionnaire.(Results)There were 7356 patients in group A,and the success rates of HbA1c,blood pressure,blood lipid profile and BMI were 30%,25.8%,32.6% ~ 81.3% and 50.9%,respectively.Except for the parameter of high-density lipoprotein,the other rates were higher than the responding ones of group B.There were 1367 patients in group C, and the success rates of main metabolic indexes were higher than those of group A and B.The result of the questionnaire indicated that poor understanding of diatetes,lack of health education,and relative scarcity of diplomate were the main factors that influenced the disease control. Conclusion The disease control of most of the type 2 patients with diabetes are far from satisfaction.The application of scientific disease care system is effective for improving the disease control.

Objective To explore the new diabetes care model. Methods A new flow for diabetic outpatient to visit the doctor, a uniform system for diagnosis,treatment and follow-up,an electronic medical record system,and a long-term diabetes education which mainly delighted patients on "diabetic self-management" were established.(Results)The service quality from the medical staff were improved markedly.Database including the clinical data of 10 020 patients and 2 563 serum samples and DNA samples were built up.A set of diabetes care model that laid the foundation for clinical and research work was formed. Conclusion Long-term education for patients with diabetes mellitus constitues the basic and important part of diabetic care model.The application of computer in diabetic care is the effective means.It is necessary to establish a uniform scheme for diagnosis,treatment and follow-up for the patients,and the improvement of medical staff's professional making ensures the successful implementation of the model.The combination of clinical practice and research work propels the development of scientific management model for patients with diabetes mellitus.

Brain ; metabolism ; Brain Chemistry ; Creatine ; deficiency ; Humans ; Syndrome

ObjectiveTo detect the neuropsychological performances of vascular dementia(VD) and the varied patterns when the severity of VD progressed. Methods39 patients who fulfilled with National Institute of Neurological and Communicative Disorders and Stroke/the Alzheimer's Diseases and Related Disorders Association(NINDS AIREN) criteria for "probable vascular dementia"were assessed with the neuropsychological scales, including Mini Mental State Examination (MMSE), Blessed Dementia Scale (BDS), Clinical Memory Scale, Wechsler Adult Intelligence Scale Revised China (WAIS-RC) and Clinical Dementia Rating (CDR), to measure the change of orientation to time and place, memory, language, visuospatial skills, cognitive function, personality characteristics, the activities of social and daily living and self maintenance. Patients were divided into mild, moderate and severe categories according CDR scores.ResultsAmong mild, moderate and severe categories, significant differences (P<0.05) were detected in the following subtests: orientation to time of MMSE, digit span, block design, object assembly, arithmetic of WAIS-RC, memory quotient, the activities of social and daily living and self maintenance of BDS. In moderate/severe and mild/severe categories, significant differences (P<0.05) were detected in the MMSE language subtest, WAIS-RC comprehension subtest and verbal intelligence quotient. Significant differences were detected in MMSE orientation to time subtest and WAIS RC similarities subtest only between mild/severe categories (P<0.05). In the MMSE immediate or delayed recall, drawing, simple calculation subtests, and BDS personality subtest, no significant differences were detected among mild, moderate and severe categories (P>0.05). Conclusions Patients with mild VD showed general deterioration of orientation, memory, language, visuospatial skills, cognitive function, personality characteristics, the activities of social and daily living and self maintenance. However, the speed of deterioration of each item was different when the severity of VD progressed. No close correlation was observed between personality characteristics alteration and the severity of VD. From mild to moderate and moderate to severe VD, the speed of deterioration of part of the cognitive function, especially the knowledge ever acquired, was slow relatively. The other aspects continued deteriorating in all stages of VD.

[Objective]To observe the effect of treating hallux valgus with modified Mitchell operation.[Method]A total of 18 cases(28 feet) of hallux valgus were treated with modified Mitchell operation from Apr.2000 to Oct.2003.The average preoperative hallux valgus angle(HVA) was 30.5 according to the X-ray images,while the average intermetatarso-phalangeal angle(IMA) was 13.5.The difference between the modified Mitchell operation and normal one was that only one transverse osteotomy need to be carried out in the distal metatarsal without lateral ridge left.The distal position of osteotomy was extended according to the sum of IMA and then moved to the metatarso side by 2~3 mm.Absorbable screws were used for fixation.[Result]All 28 feet were followed up for 10~32 months.It showed excellent result in 24 feet,good in 3,and bad in 1,with the total satisfactory rate of 92.9%.According to the postoperative weight-loading X-ray checking result,the average HVA was 15.5,with an average improving of 15;the average IMA was 8.5,with an average improving of 5.[Conclusion]The modified Mitchell operation can correct the metatarso-varus without destroying the biomechanical status.The loading function of great toe could be resumed by the removing of the first metatarso head.

AIM: To observe the effect and safety of applying mitomycin C ( MMC ) in laser - assisted subepithelial keratomileusis ( LASEK) for extreme high myopia.
●METHODS:LASEK with 0. 02% MMC was performed in 364 eyes of 182 patients with extreme high myopia and spherical equivalent was-9. 0 to-10. 25 D. All the patients were divided into four groups according to the applying time of MMC. The time in Group l was 10s, in GroupⅡwas 25s, in Group Ⅲ was 40s and 55s in Group lV. Uncorrected visual acuity ( UCVA ) , residual refraction, Haze, healing time of corneal epithelium, density and variant index of corneal endothelium was examined in these patients and follow-up 6mo.
●RESULTS:At 6mo after surgery, 76. 3%, 94. 0%, 92. 3%and 93. 8% of the patients in Group l, GroupⅡ, GroupⅢ and Group lV respectively achieved the UCVA better than 15/20. There was significant difference of UCVA between Group l and the other three groups (χ2=19. 610, P=0. 000). Proportion of the residual refraction between ± 0. 5D in Group l (78. 8%) was lower than other groups (95. 2% in Group Ⅱ, 93. 3% in Group Ⅲ, and 92. 7% in GroupⅣ) at 6mo and there was significant difference (χ2=16. 329, P=0. 001). Group l had more Haze statistically than the other three groups at 6mo postoperatively ( Hc=50. 110, P=0. 000). The healing time of cornea epithelium seem to be no statistically difference between each group at 6mo (χ2=11. 611, P>0. 05). MMC had no influence on the density of corneal endothelium in each group postoperatively (P>0. 05), there were 3071. 3±284. 4 cells/mm2 in Group l, 3 105. 6 ± 337. 8 cells/mm2 in Group Ⅱ, 2 986. 3 ± 304. 1cells/mm2 in Group Ⅲ and 3 088. 7 ± 372. 5 cells/mm2 in Group lV respectively. The variant index of corneal endothelium calculated in each group at 6mo after surgery was 24. 72 ± 6. 52, 22. 93 ± 6. 74, 24. 38 ± 6. 63 and 23. 14±7. 22 repectively, compare with that preoperatively there were no statistically differences (P>0. 05).
●CONCLUSION: For extreme high myopia LASEK with 0. 02% MMC is effective and safe. The MMC applying time of 25s in LASEK can effectively reduce Haze after surgery and decrease potential complications.

AlM:To make a analysis of visual quality of iris location guided femtosecond laser assisted in situ keratomi ( LASlK) and iris location guided mechanical sub-bowman keratomileusis ( SBK) for high myopia treatment.METHODS:Femtosecond LASlK ( study group ) was performed in 102 eyes of 51 patients with high myopia and 70 eyes of 35 patients were received mechanical SBK ( control group ) from January to October 2013. The spherical refraction of all the patients was from -6. 00 ~-9. 50D. Best corrected visual acuity ( BCVA ) of the patients was ≥1. 0. Uncorrected visual acuity ( UCVA), BCVA, thickness of cornea flap, contrast sensitivity function ( CSF ) and senior ocular aberration were examined in these patients and follow-up was 1a.RESULTS: At 1a after surgery 94. 1% UCVA in study group reached ≥1. 0 and there was 94. 3% in control group. There was no significant difference between two groups (P>0. 05). Residual refraction of study group was-0. 08±0. 10 D and control group was -0. 10±0. 07 D. There was no significant difference of residual refraction between two groups (P>0. 05). C12 , C8 of senior ocular aberration and RMSH in study group was less than control group, amplification:0.1642±0.0519 and 0.2229±0.0382 (t=8. 077, P<0. 05), while C7 was equal in two groups:0. 1583 ±0.1921 and 0. 1436±0. 1536 (t=0. 556, P>0. 05). C8 was 0. 0950±0. 069 and 0. 1858±0. 095 (t=7. 261, P<0. 05). RMSh was 0. 3711 ± 0. 0847 and 0. 5622 ± 0. 1033 ( t= 12. 801, P<0. 05). CSF was no significant difference between study group and control group (P>0. 05). CONCLUSlON: Femtosecond LASlK and mechanical SBK is effective for high myopia. Compared to mechanical SBK, femtosecond LASlK shows more advantages in the senior ocular aberration and visual quality. The cornea flap is more regular from central to peripheral area with femtosecond laser.

AIM To observe the antinociceptive effects of glucosides of Chaenomeles speciosa(GCS) and to study their relative mechanism. METHODS The effects of GCS on normal and inflammatory animals were observed in mouse acetic acid writhing test, mouse formalin test and arthritic flexion test of adjuvant arthritis(AA) rats; the concentration of prostaglandin E2 (PGE2) and tumor necrosis factor-α(TNF-α) secreted by the synovial cells of AA rats were measured by radioimmunoassay. RESULTSDifferent doses of GCS (60, 120, 240 mg·kg-1 for mice and 30, 60, 120 mg·kg-1 for rats, ig) inhibited mice′s writhing response and second phase of formalin response. It also suppressed the increased arthritic flexion scores in AA rats. On 28 d after inflammation induction, GCS (60, 120 mg·kg-1) decreased the concentration of PGE2 and TNF-α of synovial cells in the AA rats. CONCLUSIONGCS have antinociceptive effects, which related to its inhibitory effects on peripheral inflammatory mediators.