Type 2 Diabetes Mellitus(T2DM) is classified as two types according to somatotype,one is obesity or overweight,the other is normal or emaciation.It can also be classifi ed as two types according to symptoms,one is accompanied with typical syndromes(polyuria,polydipsia,polyphagia and weight loss),the other one is not.Generally speaking,the typical syndrome is not obvious among the patients with obesity or overweight,which is coincident with the theory about stuffy and fully sensation in the middle energizer and interior heat mentioned in emperor’s internal classic.So the therapeutic method is regulating the function of the middle energizer,evacuating full and stagnation,resolving phlegm and removing pathogenic heat.The typical syndrome is obvious among the patients with normal bodily form or emaciation,which is according with the traditional theory about defi ciency of yin and dryness-heat.So the therapeutic method is nourishing yin and clearing heat.The two types above are absolutely different.

QOL(quality of life) is not only one of the most important parts among the four clinical therapeutic evaluations,but also the main measurement tool to evaluate the clinical therapeutic efficiency of type 2 Diabetes Mellitus(T2DM).Based on the theory of traditional Chinese medicine,specific QOL assessment scale of TCM for T2DM should be made to evaluate the therapeutic efficiency.The assessment scale is a necessary to study T2DM of TCM.As far as TCM treating T2DM is concerned,it can also provide evidence of clinical therapeutic evaluation.

This anrticle analyses CT manifestation of 44 patients with obstructive jaundice demonstrated by surgical operation and pathological examination. It indicates that aocording to the distention of the biliary ductal system, the assured rate of the diagnosis may be attained to 100%. Aocording to the distensible range of the billiary ductal system, the assured rate of the diagnosis in the obstructive sites is 88.6 %. In combination with the disease history and the obstructive sites and the form changes of the obstructive sites, the assured rate of the diagnosis of the disease, causes is 81. 8%. This paper indicates that the malignant tumor is the main cause of the biliary ductal system obstruction. It aocounts for 72. 7%.

Objective To establish the determination method of Tubeimoside Ⅰ in Jiazhongxiao preparation and serum of rat. Methods RP-HPLC/UV method was used as follows:Diamonsil C18 column (250 mm?4.6 mm, 5 ?m) and Easyguard column, methanol-water (65∶35) as mobile phase with flow rate of 1.0 mL/min, UV detection at 214 nm. Results The mean recovery rates of Tubeimoside Ⅰ in preparation and serum of rat were (103.49?3.49)% and (104.70?4.69)% respectively. The linearity of Tubeimoside Ⅰ was shown in the range of 1.18～88.5 ?g/mL. Tubeimoside Ⅰ in preparation and serum of rat were 995.3 ?g/g and 3.19 ?g/mL. Conclusion The method was simple, reliable and rapid. It’s quite suitable to be used in the analysis of Tubeimoside Ⅰ in Jiazhongxiao preparation and serum of rat.

E2Fs transcription factors can control transcription of genes involved in cellular proliferation,differentiation and apoptosis.So far,in mammals,E2F family has seven identified members,E2F-1,E2F-2,E2F-3,(E2F-4),E2F-5,E2F-6 and E2F-7,and each of has special function.Recently,many investigations have demonstrated that E2F-1 has an apparently unique capability to induce apoptosis,and its functions relate to P53、P73、APAF-1、Caspase3 、Caspase7、BcL-2 family members、DIP、SIVA 、NF-?B factor and so on.According to the dependence on P53,molecular mechanisms of E2F-1 induced apoptosis are classified as both P53-dependent and P53-independent.Therefore,(E2F-1) is a novel target site of tumor genetherapy.

Objective: To discuss the purposes and methods of determining and employing operational intervention levels in preparedness and response for a nuclear emergency. Methods:According to the safety standards and technical reports issued by the International Atomic Energy Agency (IAEA) and combined with specific conditions in China, the operational intervention levels suitable for applying in China are analyzed. Results: The newly published IAEA technical report provided special operational intervention levels for emergency at a light water reactor. The recommended values are practical that our country can use for reference. Conclusion: It is suggested that the related branches for response to nuclear emergency in China establish feasible operational intervention levels by referring to the IAEA reports and taking into account the special conditions of nuclear facilities in China, in order to improve the capability of medical response to nuclear emergency.

Objective:To study the effects of shenmai injection on postoperative delirium (POD) in patients undergoing off-pump coronary artery bypass graft (OPCABG).Methods:40 patients undergoing OPCABG from September 2019 to March 2020 in Linyi People's Hospital were randomly divided into (group S) and control group (group C), 20 cases in each group. Shenmai injection (0.6 ml/kg)was diluted to 150 ml with 5% glucose in group S, and pumped through the central vein at the beginning of the operation. In the group C, at the beginning of the operation, 5% glucose injection (150 ml) was pumped through central vein. The values of ejection fraction (EF), cardiac output (CO), stroke volume (SV), stroke volume variation (SVV), bispectral index (BIS), oxygen partial pressure (PO 2), central venous oxygen saturation (ScVO 2) and lactic acid (LAC) at anesthesia induction (T 0), at the beginning of operation (T 1), at the beginning of coronary artery bypass graft (T 2), at the end of coronary artery bypass graft (CABG) (T 3), and at the end of operation (T 4) were recorded. Patients were evaluated for delirium on the 3rd and 7th day after surgery. Results:The EF, CO in the patients of group C and group S at T 2 were found to be significantly lower than those at T 0 ( P<0.05). The ScVO 2, PO 2 in the patients of group C and group S at T 4 were found to be significantly lower than those at T 0 ( P<0.05). The EF, CO and SV in the patients of group S at T 3 to T 4 were found to be significantly higher than those in group C ( P<0.05). The incidence of postoperative delirium on the third day in the group S was significantly lower than that in the group C ( P<0.05). Conclusions:Shenmai injection can improve the cardiac function and reduce the incidence of POD in patients with OPCABG.

Objective To compare the clinical effect of digital orthopedic three-dimensional visualization technology combined with image-based computer navigation and simple image-based computer navigation for percutaneous screw fixation of acetabulum anterior column fractures.Methods A retrospectivecase-control analysis was made on 19 cases undergone percutaneous screw fixation of acetabular anterior column fractures under image-based computer navigation from January 2015 to 2016 March.There were 12 males and 7 females,aged from 21 to 66 years (mean,39.3 years).AO fracture classification was A3 type in 17 cases and B1 type in 2.Based on the application of three-dimensional digital programming,the cases were assigned to two groups:group A (n =9),virtual three-dimensional model was reconstructed and the virtual screw were inserted to uninjured side by software Mimics and group B (n =10),patients were only prepared for routine preoperative preparation.Time of anterior column screw insertion,intraoperative bleeding,intraoperative fluoroscopy frequency,fracture reduction and Majeed score were compared between the two groups.Results All cases were followed up for mean 8.4 months (range,3-12 months).There were no significant differences between groups A and group B in iutraoperative bleeding [(14.1 ± 3.0) ml,(15.1 ± 2.2) ml],good to excellent rate of reduction (89％,80％),good to excellent rate of Majeed score (89％,80％) (P ＞ 0.05).Time of anterior column screw insertion [(22.4-± 3.4) min] and intraoperative fluoroscopy frequency [(24.9 ± 3.8)times] in group A were significantly less than those[(29.4 ± 4.5)min,(30.5 ± 5.8)times] in group B (P ＜ 0.05).Conclusion Digital orthopedic three-dimensional visualization technology is associated with shortened time of anterior column screw insertion and reduced intraoperative fluoroscopy frequency,indicating an effective adjuvant technique for percutaneous screw fixation of acetabulum anterior column under navigation.

Objective To investigate the effect of CD40/CD40 ligand on the genesis and development of coronary artery disease (CAD),and the inhibitory effect of cyclosporine A (CsA) on CD40/CD40 ligand. Methods A total of 71 patients were divided into four groups:acute myocardial infarction group (AMI, n=19), unstable angina pectoris group (UAP, n=18), stable angina pectoris group (SAP, n=17) and normal control group (N, n=17). Flow cytometry was used to detect the expres?sion of CD40 and CD40L in peripheral blood mononuclear cells (PBMCs) of four groups. The group in which CD40 and CD40L were produced at the highest level was chosen, and a series concentrations of CsA(H1:0 mg/L, H2:0.01 mg/L, H3:0.1 mg/L, H4:1 mg/L)were used to treat the cells. Then the expressions of CD40 and CD40L were measured by flow cytome?try. Results Compared with N group,the expression of CD40 was significant higher in other groups (P<0.05). The expres?sion of CD40 was significant higher in UAP group and AMI group than that of SAP group. There was no significant difference in the expression of CD40 between UAP group and AMI group (P>0.05). The expression of CD40L was elevated and fol?lowed by different severity of CAD. There was significant difference in the expression of CD40L between groups (P<0.05) . AMI group showed the highest expression of CD40 and CD40L. After being treated with CsA, the expression of CD40 was higher in H1 group than that of H3 group and H4 group (P<0.05). The expression of CD40L was significantly higher in H1 group than that of other three groups (P < 0.05). Conclusion CD40 and CD40L may be involved in the development of CAD. Moreover, it might be restrained by CsA via regulation of CD40/CD40L.

BACKGROUND:Enriching material for bone marrow stem cells is a current research hotspot. Preparation and screening of a new type of bone marrow stem cells-enriched material is crucial for the development of tissue engineering and clinical applications. OBJECTIVE:To observe the surface character and effect of a new type of bone marrow stem cells-enriched material on enriching bone marrow stem cells of decalcified bone matrix decorated with poly-L-lysine by selective cellretention technology. METHODS:Decalcified bone matrix was decorated with poly-L-lysine as the scaffold material. Bone marrow mesenchymal stem cells were col ected by using selective cellretention technology. Control group was decalcified bone matrix and experimental groups were Decalcified bone matrix decorated with poly-L-lysine at different concentrations (0.01%, 0.05%, 0.1%, 0.5%, 1%) with freeze-drying method. Material components were analyzed by Raman spectrum and infrared spectrum. Pore size, porosity, surface and cross section were observed under three-dimension video microscope and scanning electron microscope. The number of bone marrow nucleated cells, fibroblast colony-forming units and platelets were counted pre-and post-enrichment. RESULTS AND CONCLUSION:Decalcified bone matrices were covered with wel-distributed and dense poly-L-lysine. The poly-L-lysine/decalcified bone matrix had a high porosity with much more internal y connected pores. After enrichment with enriched material prepared by 0.1%poly-L-lysine, the number of bone marrow nucleated cells, fibroblast colony-forming units and platelets were increased (3.18±0.31), (5.25±1.40) and (3.88±0.68) times, respectively;the binding efficiency were (53±12)%, (73±13)%and (34±10)%, respectively;the selective rate of fibroblast colony-forming units was 1.41±0.34. The new constructed poly-L-lysine/decalcified bone matrix has good three-dimension space with high selective retention. It is an effective enriching material for bone marrow mesenchymal stem cells.