Aim To investigate the renoprotective effect of berberine in diabetic nephropathy rat model. Methods The rat model of DN was induced by intra-peritoneal injection of streptozotocin ( STZ ) after fed with high sugar and high fat diet for six weeks. The rats were divided into 5 groups randomly, i. e. normal control group, model group, BBR ( 50 mg · kg-1 ) , BBR ( 100 mg · kg-1 ) and BBR ( 200 mg · kg-1 ) treatment group. The fasting blood glucose ( FBG) was evaluated at 2, 4, 6,8 week respectively. The patho-logical changes in the kidney were determined by PAS staining. The expression of vascular endothelial growth factor ( VEGF) was detected by immunohistochemistry and Western blot respectively. Results Compared with normal control group, the value of FBG, SCr, BUN and UTP of model group were sharply increased.
Compared with model group, the value of FBG in ber-berine different dosage treatment groups were signifi-cantly decreased to various degrees, and berberine dif-ferent dosage treatment could decrease the levels of SCr, BUN and UTP in different degree. Berberine could surpress the alterations of pathological changes in the kidneys and downregulate the expression levels of VEGF in the kidney of diabetic rats with nephropathy. Conclusion Berberine could significantly ameliorate the biochemical indicators and renal injury of the model rats through affecting the abnormal expression levels of VEGF in the kidney.

Aim To investigate the effect of berberine on the expression of nephrin, podocin and intergrinα3β1 in diabetic nephropathy ( DN ) rat model, and further probe in to the renoprotective effects of berber-ine and its potential mechanisms. Methods The rat model of DN was induced by intraperitoneal injection of streptozotocin ( STZ ) after fed with high-sugar and high-fat diet for six weeks. The rats were assigned into 6 groups randomly: normal control group, DN model group, BBR (50,100 and 200 mg·kg-1 ) treatment group and enalaprilat positive control group ( 1 mg · kg-1 ) . The distribution and expression of kidney podocyte related proteins nephrin, podocin and interg-rinα3β1 were detected by immunohistochemical meth-od following electron microscopy observation ( × 1000 ) and high magnification observation( × 400) and West-ern blot. Results The podocyte related protein neph-rin, podocin and intergrin α3β1 were mainly distribu-ted in podocyte, but slightly different. Compared with normal control group, the expresion of podocyte related protein nephrin, podocin and intergrin α3β1 was de-creased obviously; compared with model group, BBR (100 and 200 mg·kg-1 ) treatment group could sig-nificantly suppress the abnormalities of pathological changes of the kidney and upregulate the expression levels of podocyte specific protein nephrin, podocin and intergrin α3β1 in the kidney of diabetic rats with nephropathy. Conclusions Berberine could alleviate the abnormalities of kidney pathological changes and proteinuria production in the DN model rats, which may be related to the upregulation of the expression of the podocyte proteins nephrin, podocin and intergrinα3β1.

BACKGROUND: As a blood concentrate rich in growth factors and fibrin, platelet-rich fibrin (PRF) is able to significantly promote bone regeneration. PRF mixed with bone substitutes is commonly used to repair bone defects in oral maxillofacial region. But it remains controversial whether PRF as a sole material in sinus floor elevation can produce enough new bone tissues.OBJECTIVE: To evaluate the osteogenic potential of PRF as a sole grafting material in sinus floor elevation by means of an animal model.METHODS: Twelve healthy adult mongrel dogs aged 12-18 months were selected and randomized into three groups (groups A, B and C), with four dogs in each group. Upper first molars on both side of each dog were extracted 12 weeks prior to sinus floor elevation and simultaneous implants placement. Different materials were used to fill in the space between the sinus membrane and implant. Groups A, B and C were filled with PRF, autologus bone particles and autologus blood clot respectively. After 12 weeks, specimens were harvested to analyze the new bone formation by gross observation, X-ray examination and histological evaluation.RESULTS AND CONCLUSION: New bone formation was found to embrace all the implants close to the bony sinus floor, and the tips of all implants were free from bone coverage. The new bone height of groups A, B and C were (3.135±0.288),(3.218±0.345), and (1.898±0.157) mm, respectively. The new bone density of groups A, B and C were (65.06±5.88),(75.34±8.18), and (56.92±4.95) g/cm3, respectively. There were significant differences between the new bone height in groups A and C as well as in groups B and C (P < 0.05). Also, significant differences were found between the new bone density in groups A and B, B and C, A and C (P < 0.05). Within the confine of this experiment, it is feasible to use PRF as a sole grafting material in the sinus floor elevation to generate new bone, but the new bone volume is limited.

Objective To evaluate efficacy and safety of intravenous chemotherapy combined with TACE in the treatment of gastric cancer with hepatic metastasis.Methods In this study 60 gastric cancer patients with hepatic metastasis were divided into two groups randomly,the trial group (30 cases) took intravenous chemotherapy consisted of docetaxel 60 mg/m2 intravenous drip d1,oxaliplatin 80 mg/m2 intravenous drip d1 followed by 5-fiuorouracil 500 mg/m2 intravenous drip d1-5 after TACE.The control group (30 cases) took the same chemotherapy protocol and one treatment cycle covering 4 weeks.Results The overall response rate in trial group was 53％ and the increase rate of Karnofsky was 70％ while that was 37％ and 40％ respectively in the control group (P ＜ 0.05).The median overall survival of trial group was 13 months and which was 8 months in the control group (P ＜ 0.05),meanwhile the toxicities and side reactions of trial group didn't increase notably.Conclusions Intravenous chemotherapy combined with TACE is safe and more effective in the treatment of gastric cancer with hepatic metastasis.

ObjectiveTo discuss the relationships among spastic paralysis and motor function, balance function and other clinical variables after stroke.MethodsAssessed the clinical spastic index of hemiplegic lower limbs with CSI scale, motor function with Fugl-Meyer Assessment, and balance function with Berg Equilibrium Scale, respectively. And then analyzed the relationship between clinical spasm index with motor function, balance function of the hemiplegic lower limbs with Pearson correlation analysis. Finally, ascertained which was the most important factor affecting the clinical spasm index of spastic lower limbs with stepwise regression analysis.ResultsThere is negative correlation between clinical spasm index with motor function and balance function, respectively. Tendon reflex, muscular tension and clonus are the deciding factors to motor function(P<0.05) and balance function(P<0.05) of the hemiplegic lower limbs.ConclusionThe clinical spasm index of hemiplegic limbs can affect the recovery of motor function and balance function significantly. So, assessing and improving the clinical spasm index of paralytic lower limbs can optimize the rehabilitation program to stroke patients.

Objective To investigate the incidence and predictors of cerebral infarction in patients with ruptured ACoA aneurysms, and to provide diagnostic and therapeutic information.Methods A total of 319 patients with ruptured ACoA aneurysms in our hospital from January 2009 to February 2015 were reviewed in this study. The author collected data regarding clinical characteristics, and measured the aneurysm morphologies on CTA images. Age, flow angle, vessel angle were analyzed by independent-samples t tests in patients with or without cerebral infarction. Mann-Whitney U tests were used for aneurysm size, aneurysm height, perpendicular height, neck size, size ratio, aspect ratio, aneurysm angle , World Federation of Neurosurgical Societies (WFNS) grade at admission and Fisher grade. Chi-square tests and Fisher's exact tests were used for sex, histories of hypertension, smoking and stroke, treatment modalities, anterior cerebral A1 segment configuration and angiographic vasospasm on CTA images. The multivariate logistic regression analyses were used to determine the independent risk factors of cerebral infarction using the stepwise regression method. Results Of the 319 patients, there were 253 without and 66 patients with cerebral infarction. Differences of age(53±11 vs 57±12,respectively;t=-2.415, P=0.016), Fisher grade [Ⅰ 23(9.1%), Ⅱ 27(10.7%), Ⅲ 74(29.2%), Ⅳ 129(51.0%) vs Ⅰ 1(1.5%), Ⅱ 7 (10.6% ), Ⅲ 13(19.7% ), Ⅳ 45(68.2% ), respectively;Z=-2.541, P=0.035] and treatment modalities [endovascular coil embolization 155(61.3% ), neurosurgical clipping 98(38.7% ) vs endovascular coil embolization 23(34.8%), neurosurgical clipping 43(65.2%), respectively;χ2=14.810, P<0.001] reached statistical significance. Multivariate analysis showed that Fisher grade Ⅳ(OR=10.36,95%CI 1.34-80.29, P=0.025) and neurosurgical clipping (OR=3.28, 95% CI 1.84-5.86,P<0.001)still had statistical significance. Conclusions Cerebral infarction in patients with ruptured ACoA aneurysms may be associated with Fisher grade and treatment modalities. Although there is difference between the two groups in age, it is not a predictor of the occurrence of cerebral infarction.

OBJECTIVE：To explore high-alert drug management mode of our hospital ，and to provide reference for the management and utilization of this category in medical institutions. METHODS ：According to High-alert Drug Catalog （2019 edition）issued by Hospital Pharmacy Committee of Chinese Pharmaceutical Association ，the high-alert drug catalog of our hospital and their risk points were formulated. Relevant training and assessment were conducted for physicians ，pharmacists and nurses throughout the hospital. Using qualification rate of high-alert drug management and utilization as index ，the effectiveness of high-alert drug management and utilization were compared before and after optimization. RESULTS ：In our hospital ，the risk of high-alert drugs was controlled by establishing inspection and supervision group ，pharmacist education ，information management ， prescription review and individualized administration ，medication guidance ，prescription review and medication error reporting and other measures and with continuous optimization. Compared with before optimization ，qulification rate of high-alert drug management and utilization increased from 37.3％ to 80.1％ in clinical departments （P＜0.01），and that increased from 59.2％ to 85.0％ in pharmacy department （P＜0.01）. There were still some problems ，such as the inconsistency of high-alert drugs accounts and materials ，the failure to report all medication errors in time ，the imperfect establishment of prescription review software rules ， the insufficient medication guidance ，and the lack of individual medication varieties. CONCLUSIONS ：By optimizing the management of high-alert drugs ，the management and utlization of this category is improved effectively in clinical departments and pharmacy departments of our hospital.

【Objective】 To investigate the correlation between human platelet antigens (HPA) polymorphisms and platelet parameters. 【Methods】 The HPA-2, HPA-3, HPA-5 and HPA-15 genotypes of 139 healthy Chinese Han individuals were detected using TaqMan-MGB probe real-time PCR, while platelet parameters including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet-large cell ratio (P-LCR) were measured using hematology cell analyzer. 【Results】 The PLT was significantly lower in the individuals with HPA-2aa genotype compared to those with HPA-2ab [(234.35±50.10)×10³/μL vs (269.58±41.66)×10³/μL, P<0.05], while the PLT was significantly higher in individuals with HPA-5aa and HPA-15aa genotypes compared to those with HPA-5ab and HPA-15ab/bb [HPA-5: (239.36±49.81)×10³/μL vs (200.29±48.02)×10³/μL; HPA-15: (251.00±58.41)×10³/μL vs (231.29±45.20)×10³/μL, P<0.05], respectively. The MPV, PDW and P-LCR were significantly lower in individuals with HPA-5aa genotype compared to those with HPA-5ab [mpv: (10.01±0.72)fL vs (10.94±1.01)fL; PDV: (11.94%±1.35%) vs (14.25%±2.78%); P-LCR: (25.32%±5.03%) vs (31.73%±6.39%), P<0.05], but did not differ among the HPA-2 and HPA-15 genotypes. Besides, no significant differences in platelet parameters of individuals with HPA-3aa and HPA-3ab/bb genotypes were notable(P>0.05). HPA-2, -5 and -15 polymorphisms were identified as independent factors for platelet count, and HPA-5 polymorphism was an independent factor for platelet volume, revealed by multiple linear regression analysis. 【Conclusion】 HPA-2, -5 and -15 polymorphisms are correlated with platelet count, and HPA-5 polymorphism is correlated with platelet volume.

【Objective】 To study the frequency, Rh phenotypes and molecular & biological background of D-elute (D^el) phenotype in RhD-negative blood donors in Dalian. 【Methods】 A total of 355 serologically RhD-negative samples between November, 2018 and October, 2019 in Dalian Blood Center were collected, and tested for RhC, c, E, e phenotypes using monoclonal antibodies and anti-D adsorption/elution test. DNA was extracted by magnetic bead selection. RHD 1227G>A mutation was detected by melting curve analysis. All RHD exons were sequenced by Sanger sequencing. 【Results】 Among 355 serologically RhD-negative blood donors, 55 (15.5%) were identified as D^el and the remaining 300 cases (84.5%) were true RhD negative. Ccee (45/55, 81.8%) was the predominant Rh phenotype among 55 D^el cases while ccee (210/300, 70.0%) was the most prevalent Rh phenotypes in 300 true RhD negative cases. In 55 D^el cases, 51 (92.7%) had RHD 1227G>A mutation, and the other 4 cases(7.3%) had mutations in other sites. 【Conclusion】 The frequency of D^el was 15.5% in serologically RhD-negative blood donors in Dalian, with Ccee being the most prevalent Rh phenotype and RHD 1227G>A the most common gene mutation.

OBJECTIVE：To provide method reference for scientifically eva luating the rationality of the use of saxagliptin . METHODS：Based on the drug instructions ，clinical guidelines ，clinical pathways ，related references ，clinical endocrinology department and pharmaceutical experts of a hospital jointly discussed and formulated the evaluation criteria for the rationality of the use of saxagliptin. AHP method was used to assign weights to various indexes of evaluation criteria ；TOPSIS method was used to analyze the use of saxagliptin of 106 cases in the hospital during Nov. 2018-Apr. 2019 retrospectively and evaluate rational drug use. RESULTS ：A total of 6 primary indicators and 12 secondary indicators were established. The first three indicators with a relatively high index weight were indications （with a weight of 0.25），dose and adjustment of administration （with a weight of 0.21）and frequency of administration （with a weight of 0.15）. Among 106 cases，39.6％ of drug use were reasonable ，51.0％ were basically reasonable and 9.4％ were unreasonable. Evaluation results made by weighted TOPSIS were consistent with the actual situation. CONCLUSIONS ：TOPSIS method weighted by AHP is reasonable and feasible for evaluating the rationality of saxagliptin use.