Weighted topsis method is applied to evaluate the key factors in medical management of diabetes mellitus.The key factors are admission examinations,drug selection,patient serf-management skills,nursing quality,and physicians'capability.

Objective To investigate the neuroprotective effects and mechanisms of 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/ IMP cyclohydrolase(AICAR) supplement (AMPK activator) in different stages of neonatal rats sufferring from hypoxia-ischemia encephalopathy ( HIE). Methods Neonatal rat hypoxia-ischemia brain injury model was employed in this study. A total of 160 neonatal rats were distributed into five groups: sham, model control,AICAR30 min, AICAR24 h and AICAR72 h. The neuroprotective effects of AICAR supplement (30 min, 24 h, 72 h post operation) were compared by cresyl violet staining; Expressions of P-AMPK,AMPK in the brain tissue were measured by Western blotting.Foot-faults method was used to evaluate the long-term prognosis of the rats. Results Compared with the sham group, the survival of rats brain in model control group was significantly decreased [(100.0± 0.1)% and (45.3± 6.3)%, P< 0.05]. AICAR had neuroprotective effects when treated at 30 min and 24 h post operation,while the protective effects disappeared when treated later (72 h post operation) (P>0.05). Compared with the sham group, the expression of P-AMPK significantly increased about three times, while ATP level decreased close to the same. Conclusion Early AICAR treatment can protect hypoxia-ischemia brain injury by increasing AMPK-ATP level.

Objective To analyze postoperative effect of a new rectopexy technique with Douglas pouch elevation for complete rectal prolapse (CRP) in adults.Methods From January 2010 to May 2011, 52 CRP cases were treated by rectopexy with Douglas pouch elevation.In terms of different surgical techniques, patients were divided into two groups : Group A (n =28) received laparoscopic rectopexy with Douglas pouch elevation;and Group B (n =24) received laparoscopic rectopexy with Douglas pouch elevation combined with procedure for prolapse and hemorrhoids (PPH).Rectal prolapse, constipation, and fecal incontinence in the two groups were assessed respectively before surgery, and on the 6th, 12th, and 24th month after surgery, postoperative complications were evaluated with severe grading of surgical complications.Results Symptoms of rectal prolapse disappeared at half a year after surgery in all patients, and relapsed to different extent afterwards.However, two years after operation, the status of rectal prolapse in Group B tended to be stable.The trend of constipation after surgery was consistent with that of rectal prolapse.In addition, fecal continence improved gradually on half a year after surgery in the two groups and recovered to the optimal status in the first postoperative year.However, in the second year, the results of fecal incontinence reduced slightly in Groups A, and Group B became stable.Two years after surgery, four cases in Groups A relapsed while there was no recurrence in Group B.Difference of Grade I to Grade Ⅲ complications among the two groups was statistically insignificant (x2 =0.05, P ＞ 0.05).Conclusions The clinical effect of laparoscopic rectopexy with Douglas pouch elevation associated with the procedure for prolapse and hemorrhoids (PPH) is better than that without PPH for female and male CRP patients with severe symptoms.

As a kind of commonly used traditional Chinese medicine, ginseng has a high reputation at home and abroad. The research of ginseng has been expanded to medicine, pharmacy, biology, food science and other fields, with great achievements in recent years. Ginseng contains ginsenosides, volatile oil, carbohydrates, amino acids, polypeptides, inorganic elements and othser chemical constituents. Each component has extensive physiological activity, and is the base of ginseng's effect. After processing, the complicated changes are taken place in the constituents of ginseng, and some new substances produced. This paper aims to review the studies on chemical constituents and their mechanisms during ginseng processing, and the ideas, methods and the direction of the development of traditional Chinese medicine processing in the future.
Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; Panax ; chemistry ; Plants, Medicinal ; chemistry

The primary processing is important links and closely related to the quality of traditional Chinese medicinal materials, and is not only cleaning of remove the non-officinal parts, drying for termination the physiological status of organisms, but also retaining the most active substances, decreasing the toxic components, and promoting the transformation among chemical ingredients through primary processing. So the traditional primary processing endows with characters, quality, specifications and properties of traditional Chinese medicine, and embodies some important science truth. The traditional primary processing method and technology systems are derived from the long-term practices and experiences, which are distinctive, colorful, diverse, and scientific, which are helpful to development and utilization of traditional Chinese medicine resources. This paper systemically expounds the research status of the Chinese medicine processing method, summarizes the problems in the primary processing of traditional Chinese medicinal materials research, and prospects its bright future.
Chemistry, Pharmaceutical ; methods ; trends ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Medicine, Chinese Traditional

AIM: To compare the safety and efficacy of conjunctival autograft transplant ( CAT ) and limbal - conjunctival autograft transplant (LCAT) for primary pterygium.
METHODS: In this prospective, randomized and controlled clinical study, 120 patients ( 120 eyes ) diagnosed with primary pterygium were collected in NO. 474 Hospital of Chinese PLA from January 2014 to January 2015. The 120 patients enrolled in the study in turn, and divided into two group by the odd and even number. The odd number underwent CAT and the even number underwent LCAT.
RESULTS:One hundred and seven patients (107 eyes) completed the follow-up of 1a, including 54 patients (54 eyes) from the CAT group and 53 patients (53 eyes) from the LCAT group. Four patients (4 eyes, recurrence rate 7. 4%) in the CAT group and 2 patients ( 2 eyes, recurrence rate 3. 8%) in the LCAT group developed recurrence. However, there were no significant in recurrence rate between CAT group and LCAT group (P =0. 678).
CONCLUSION: CAT and LCAT might be both effective treatment for primary pterygium for reducing the recurrence rate of pterygium. However, LCAT is the optimal surgical method for primary pterygium.

Objectives To explore the effect of erythromycin on glutathione hormone (GSH) and γ-glutamyl cysteine synthetase (γ-GCS) in premature newborn rats exposed to hyperoxia, to study the intervention effect of erythromycin on hype-roxia-induced lung injury. Methods One-day old preterm SD rats were randomly divided into four groups:control group, eryth-romycin group, hyperoxia group, erythromycin+hyperoxia group. Hyperoxia group and hyperoxia+erythromycin group were continuously exposed to oxygen (oxygen concentration>0.85), control group and erythromycin group were in room air. Via cau-dal vein, the preterm rats was injected with erythromycin in erythromycin group and hyperoxia+erythromycin group, sodium chloride in control group and hyperoxia group daily. After 1,7,14 day(s) of hyperoxia (or air ) exposure, the preterm SD rats of four groups were killed, whole lung of these rats were isolated and histological changes were observed by hematoxylin-eosin (HE) staining, GSH andγ-GCS of pulmonary tissue homogenate were detected by double antibody sandwich enzyme linked im-munosorbent assay. Total lung RNA was extracted andγ-GCS mRNA was detected by reverse transcription polymerase chain re-action. Results The results showed that:After 1 and 7 day(s) of exposure, the expression of GSH、γ-GCS andγ-GCS mRNA in four groups showed significant differences(P<0.05). Among them, GSH expression in erythromycin + hyperoxia group was higher than that in the other three groups in 1,7,14 day(s) of exposure with significant differences (P<0.05);GSH expression in erythromycin+hyperoxia group and hyperoxia group reached the peak after 7 days of exposure. The expression ofγ-GCS andγ-GCS mRNA in erythromycin+hyperoxia group and hyperoxia group were higher than the other two groups after 1and 7 day(s) of exposure, the expression ofγ-GCS mRNA in erythromycin+hyperoxia group were higher than that of hyperoxia group with significant differences (P<0.05). Conclusions The expressions of GSH andγ-GCS in the lung of premature SD rats were abnor-mal by oxidation outbreak. Erythromycin may increase the activity ofγ-GCS, improve the anti-oxidation ability of GSH, and al-leviate hyperoxia mediated lung injury in premature rats.

Objective To investigate the feasibility and safety of retroperitoneal laparoendoscopic single-site (LESS) donor nephrectomy using home-made single-port device.Methods From January 2011 to June 2012,11 consecutive LESS left donor nephrectomies using home-made single-port device with conventional laparoscopic instrument were performed through retroperitoneal access in our center.Results The procedures were completed and no complications occurred in all donors.Mean operative time was 149.5 min.Estimated blood loss was 30-350 ml.Warm ischemia time was 2-4 min.The urine output was prompt in all cases.Recipient graft function was normal within 2 weeks.Donor hospital stay was 5-6 days after operation.Conclusion LESS donor nephrectomy using home-made single-port device in our initial experience is feasible and safe.It is also cost-effective and minimally invasive with conventional laparoscopic donor nephrectomy.This technique is a good option for living donor nephrectomy.

Objective To observe the phosphorylation of Smad3 in hyperplastic scar fibroblasts (HSFs) induced by hematoporphyrin monomerthyl ether (HMME) followed by photodynamic therapy (PDT).Methods Fibroblasts were isolated from the hypertrophic scar tissues of 10 patients and subjected to culture in vitro.After 3-5 passages,the HSFs were divided into 4 groups:control group receiving no treatment,PDT group pretreated with HMME of 4 μg/ml followed by PDT,HMME group induced by HMME alone,and laser group irradiated with laser alone.Fluorescence microscopy was used to observe the expression of Smad3 after immunofluorescent staining with anti-Smad3 antibody,and Western blot to detect the expression of Smad3 and phosphorylated Smad3 in these HSFs.Paired t test was conducted to compare the difference in Smad3 and phosphorylated Smad3 expression between these groups.Results The total fluorescence intensity of Smad3 was similar between these groups,but the intranuclear fluorescence signal was significantly weaker in the PDT group than in the control group.The level of phosphorylated Smad3 was statistically decreased in the PDT group compared with the control group (0.20 ± 0.02 vs.0.92 ± 0.15,P ＜ 0.05),but no significant difference was observed between the HMME group and laser group (P ＞ 0.05).Conclusion PDT may inhibit the proliferation of HSFs via attenuating the phosphorylation of Smad3.

Objective To sum up experience with surgical excision of isolated local recurrence for renal cell carcinoma. Methods From March 2004 to November 2007, 7 patients (five cases un-derwent radical nephrectomy and two nephron-sparing surgery) with isolated local recurrence of renal cell carcinoma were treated at our department. All patients underwent extensive surgery for local re-currence. Results The mean patient age was 42 years (range 19 to 6). The mean time to local re-currence was 23.3 months (range 12 to 54). The Mean size of the recurrent tumor was 5.2 cm(range 2.5 to 10.5). Peritoneal exploration was performed in 7 patients and 5 had complete en bloc excision of the renal cell carcinoma mass. 2 patients gross disease was excised. The mean blood loss was 1050 (150-3000) ml. Surgical complications occurred in 2 patients, iliohypogastric nerve injure in one and ileus performation in another one. All patients recovered finally. Six patients were followed and one lost follow-up. Mean follow-up time was 13(8-27) months. One patient died of metastatic disease at 22 months after excision of the renal cell carcinoma mass. Conelusion En bloc excision of isolated locally recurrent renal cell carcinoma is possible, and complete surgical resection could lead to pro-longed disease-free survival.