Objective To study the effects of supra-physiologic glucose on the expression of PDX-1 and insulin secretion. Methods Islet cells isolated from SD rats were incubated in medium containing 5.6 mmol/L or 33 mmol/L glucose respectively for 3 days. Basic and glucose-induced insulin levels in supernate and in islet cells were detected. The PDX-1 mRNA and protein were detected. Results (1) Islet cells exposed to 33 mmol/L vs 5.6 mmol/L glucose for 3 days showed significant decrease in the basic and glucose-induced insulin release, and in cell insulin content and PDX-1 protein. (2) Prolonging incubation of islet cells in 33 mmol/L glucose aggravated the inhibitive effect on PDX-1 expression and insulin secretion. (3)Recovery to normal concentration of glucose in 3 days could partly improve PDX-1 expression and insulin secretion. Conclusions Inhibition of PDX-1 is one of the mechanism of glucotoxicity, and recovery to normal concentration of glucose in 3 days can partly improve PDX-1 expression and insulin secretion.

To explore the new pattern of Chinese medicine solid preparations (CMSP) in vitro dissolution, a method testing the bio-thermal activity in combination with UPLC was used. Microcalorimetry was used to obtain the characteristic metabolic growth power-time curves and a series of biothermodynamic parameters of the inhibition of Staphylococcus aureus by Yinhuang tablet dissolving solutions at the pH 6.8 (phosphate buffer) dissolution medium at different times. From these results, the cumulative dissolution of Yinhuang tablet based on bio-thermal activity was obtained. The dissolution rates of two components of chlorogenic acid and baicalin were determined by UPLC method. Then f2 similar factor method was used to evaluate the relevance of these two methods. The result showed that f2 values all were more than 50, indicating that there is a good correlation between the two methods of measuring the dissolution rate. It is feasible to determine CMSP in vitro dissolution by using bio-thermal activity, and to provide new evaluation methods for controlling the quality of CMSP.

Objective:To observe the expression of connective tissue growth factor(CTGF) and its receptor-low density lipoprotein receptor-related protein (LRP), and the relevant signaling pathway for the regulation by long-term high glucose exposure in cultured podocytes. Methods:The effects of high glucose on the expression of CTGF and its receptor LRP were analyzed by western blotting. The activation of mitogen activated protein kinase ( MAPKS )signaling pathway by high glucose was also examined. Results: Basal levels of CTGF were observed in cultured mouse podocytes, the levels of CTGF protein were increased by high glucose medium groups on the 2nd day, reached the peak on the 4th day(P0.05).The levels of CTGF expression in normal glucose and mannitol glucose groups did not change markly. High glucose medium induced phosphorylation of ERK_ 1/2 at as early as minute 30, reached the peak at hour 6; maintained the activity at hours 12 and 24, and declined to the basal level at hour 48. However, phosphorylation of ERK_ 1/2 was not detected in normal glucose and mannitol glucose groups. Blockade of phosphorylation of ERK_ 1/2 with PD98059, a specific ERK_ 1/2 activation inhibitior, did decrease the high glucose-triggered expression of CTGF protein in 4 days. High glucose had no effect on the expression of LRP protein at each time point. Conclusion: Acute high glucose (2-4 days)stimulated the expression of CTGF protein via ERK_ 1/2-dependent signaling pathway in cultured podocytes, while cultured in high glucose for 6-8 days, the podocytes did not increase its CTGF level. Long-term high glucose had no effect on the expression of LRP in podocytes.

目的探讨选择性脊神经后根切断术(SPR)治疗小儿脑性瘫痪(CP)的疗效。方法对我院获取1年完整随访资料的62例SPR患儿进行回顾性分析。结果按AshWorth 5级肌力标准判断,术后下肢肌张力平均下降2.4级,上肢肌张力平均下降0.4级。术后1年患肢肌张力缓解62例(缓解率100%),行走功能和步态改善48例(77.4%)。伴随症状部分改善。结论SPR能有效缓解CP患儿肢体肌张力,改善康复条件。

Objective To explore the value of water -based material decomposition images for detection of bone marrow edema (BME)in sacroiliitis with energy spectral CT.Methods The sacroiliac (SI)joints of nine spondyloarthropathy patients with sacroiliitis (the research group)and eight healthy volunteers (the control group) were underwent MRI and energy spectral CT.The mixed energy image of energy spectral CT was reconstructed to be mono energy image.Then,the mono image was divided into water -based image and calcium image by material divid-ed and analyzed software.The SI para -articular marrow region water -calcium relative concentration of research group was compared with that of control group.The BME diagnosis efficiency and optimal water -based concentration of energy spectral CT was analyzed by receiver operating characteristic (ROC)curve.Then,the sensitivity,specificity, positive likelihood ratio and negative likelihood ration were calculated.Results The water -based concentration of BME in research group (1 067.43 ±10.84)g/L was higher than that of control group (1 039.43 ±8.01)g/L(t =-3.14,P =0.003).Meanwhile,the calcium -based concentration of research group (68.98 ±20.53)g/L was not different from control group (78.03 ±26.39)g/L(t =1.88,P =0.066).ROC curve showed that the diagnosis efficiency was medium as the area of under curve was 0.75.When the optimal concentration of water -based was 1 052.00g/L,the diagnosis efficiency was the best.The sensitivity and specificity was 84.00%,62.50% respectively. Conclusion There are reference value and potential clinical value with energy spectral CT water -based concentra-tion detection for diagnosis BME in patients with sacroiliitis.

Objective To discuss the safety and effectiveness of heat-sensitive moxibustion for bladder dysfunction after poisonous snakebite. Method Twenty-six patients with bladder dysfunction due to poisonous snakebite were intervened by heat-sensitive moxibustion, and the changes of residual urine volume and uroflowmetry parameters were analyzed by using type-B ultrasonic scanning and uroflowmetry. Result According to the ultrasonic scanning and uroflowmetry, the residual urine volume was significantly changed after treatment in the 26 subjects (P<0.05), and the maximum urine flow rate (Qmax) was also significantly different from that before treatment (P<0.05). Conclusion Heat-sensitive moxibustion can improve the residual urine volume and Qmax in bladder dysfunction after poisonous snakebite, and it’s a safe and reliable method.

Objective To evaluate the value of DWI in detecting active sacroiliitis in patients with axial spondyloarthritis ( SpA) .Methods DWI and conventional MRI examinations were done oblique coronary on bilateral SIJs of 19 participants,involving 8 patients (the case group) underwent clinical and conventional MRI evaluation for axial SpA active sacroiliitis and 11 healthy volunteers(the control group).The conventional MRI,DWI,ADC,EADC images were transmitted to two experienced radiologists respectively to read ,evaluate and measure ( the ADC values and EADC values ) at the workstation under the blind method .The experimental data were inputted and analyzed by statistics software .Results In the control group ,the periarticular bone marrow in the SIJ showed hopyintense signal on the DWI image ,hypointense signal on the ADC image and hyperintense signal on the EADC image .The periarticu-lar bone marrow oedema showed hyperintense signal on the DWI and ADC images , while hopyintense signal on the EADC image.At b values of 300s/mm2 ,the ADC values of the periarticular bone marrow oedema at each side in the case group were significantly higher than those in the control group , while EADC values were lower , the difference were statistically significant(Z=-3.115,-2.814,-3.002,-3.115,-3.115,-2.714,-2.889,-3.115,all P<0.05).Conclusion DWI can directly detect the signal changes ,extent of the periarticular bone marrow oedema , and analyze the severity of oedema quantitively ,which shows the utility in determining the activity and early diagnosis .

Objective To investigate the relationship of external hydrocephl(EH) with brain-injure in the neonate.Methods By performing on the patients with brain-injure with CT and making the clinical study,the change of brain following injure and its relationship with EH were analyzed.Results Hypoxic-ischemic encephalopathy(HIE) were 36 cases,EH were 19 in the cases,6 get the cerebrospinal symptom;SAH were 22 cases,EH were 15 in the cases,3 get the cerebrospinal symptom;Intracranial hemorrhage were 8 cases,EH were 3 in the cases,3 got the cerebrospinal symptom.Conclusion All the kinds of brain-injure can get EH and the rate of EH with any brain-injure is no different.But the outcome is significantly different.

Objective To understand the attitude and current situation of medical English stud y as well as its relevant factors among long schooling medical students so as to provide first hand information for constructing students-centered medical English teaching model. Methods A self-de-signed questionnaire including basic information of students, attitude and current situation of medical English students was given to 134 seven or eight year program clinical medical graduates from grade 2006 to grade 2008 in Tongji University. Questionnaires were collected timely and an-alyzed with SPSS 19.0 and results were described by percentage. Results Totally 132 copies of questionnaire were recovered with an recovering rate of 98.51%. 56.82%(75/132) students had interest in medical English study and 71.97%(95/132)students had a will to go abroad for learning exchange. Main pur-poses for students to learn medical English were ‘professional literature reading’(68.94%,91/132),‘SCI papers writing’(59.09%,78/132)and ‘international communication’(58.33%, 77/132). Main influencing factors of medical English study were ‘boring teaching methods ’ ( 45 . 45%, 60/132 ) ,‘difficult medical English’(41.67%,55/132) and ‘insufficient teaching time’(40.91%,54/132).Conclusions Medical students with long schooling have demand for medical English study;however, most of them have some difficulties in practical application. Measures should be taken from three as-pects including students, teachers and curriculum setting to improve students' medical English.

Objective To explore how does chymase affect diabetic cardiomyopathy by investigating the gene expression of chymase and the relationship between the gene expression of chymase and the angiotensin Ⅱ in the cardiomyopathy of streptozotocin-induced diabetic hamasters. Methods Diabetic hamsters were induced by intraperitoneal injection of STZ 40 mg/kg once a day for 3 days. After stabilization of diabetic state for 18 weeks, the myocardial ultrastructure was observed with electron microscope and pathologic changes were observed by light microscopy. Immunohistochemistry was used to measure the level of expression of type Ⅰ and type Ⅲ collagen in diabetic and normal hamster hearts. Level of blood glucose, lipoprotein was determined using biocehemical methods. Apoptosis of cardiomyocyte was measured using TUNEL methods. Radioimmunuoassay method was used to determine the level of angiotensin Ⅱ. RT-PCR was used to determine chymase gene expression (corrected by?-actin). ResultsComparing with the control group, levels of serum glucose, TG, TC, LDL in DM group were much higher. Concentrations of collagen Ⅰ, Ⅲ and angiotensin Ⅱ [(95.8?16.0)?g/kg tissue vs (51.1?20.8)?g/kg tissue] in myocardial tissue in DM group were much higher than those in control group. RT-PCR result showed: Comparing with the control group, the mRNA expression of chymase in DM group was promoted significantly (0.810?0.026 vs 0.490?0.087). Conclusion In diabetic hamsters, the gene expression of chymase were much higher than thatin the control group, accompanying higher level of Angiotensin Ⅱ, higher levels of expression of collagen Ⅰ and Ⅲ. This result suggests that chymase plays an important role in the diabetic cardiomyopathy by promoting the activity of chymase.