Objective To evaluate the clinical efficacy and safety of orlistat in Chinese overweight and obese patients. Methods In six research centers, 444 overweight and obese patients (body mass index 25～40 kg/m 2) were divided into orlistat group (296 patients) and placebo group (148 patients) with a low-energy diet for 24 weeks by a randomized, double-blinded, placebo-controlled study. Results For intent-to-treat analysis, 286 orlistat-treated and 142 placebo-treated subjects were evaluated. After 24 weeks, orlistat-treated patients lost more weight 〔(6.1?3.6)kg,( x ?s)〕 than placebo-treated patients did (3.0?3.5)kg (P

Objective To compare the efficacy and tolerability of nateglinide with those of acarbose in Chinese type 2 diabetes mellitus (T2DM) patients.Methods This multi-center,randomized,double-blind,parallel-arm study compared the efficacy and tolerability of nateglinide( 120 mg,3/d,n = 119) and those of acarbose( 100 mg,3/d,n = 118) during a 12-week treatment in T2DM patients uncontrolled by diet with glycosylated haemoglobin (HbA1c) 6.5% - 11.0% .Results Monotherapy with nateglinide (120 mg,3/d)or acarbose (100 mg,3/d)decreased HbA1c to a similar extent during 12-week treatment.The mean change from baseline to end-point in HbAlc was ( -0.90±0.98)% and ( -0.83±0.81 )% in patients receiving nateglinide and acarbose,respectively,with no significant difference between the two groups (P>0.05).The decrease in fasting plasma glucose (FPG)was similar between nateglinide and acarbose (P > 0.05).The mean change in 2-hour postprandial plasma glucose ( PG2h ) was ( - 1.45 ± 2.74) mmol/L and ( -2.20±2.21 ) mmol/L in patients receiving nateglinide and acarbose(P =0.0017).Body weight was significantly decreased in both groups at the end-point ( P < 0.05 ),although the decrease was more with acarbese than nateglinide [( -0.66±1.79)kg vs (-2.06±2.00) kg,P=0.0000].And the proportion of patients experiencing any presumed drug related adverse events was not significantly different between the two groups.Conclusions Nateglinide ( 120 mg,3/d) is effective and well tolerated in T2DM patients uncontrolled by diet,demonstrating similar HbA1c reductions as compared with acarbose (100 mg,3/d).

Objective To observe the effects of Changrui Enemas on IL-1β and NF-κB in the rat model of radiation-induced proctitis, and to explore the mechanism of its repairing mucous membrane and diminishing inflammation. Methods Radiation was given on the pelvis of rats through linear accelerator to establish the model of proctitis. 70 rats were divided into seven groups randomly. Small dose (0.4 g/ml), middle dose(0.8 g/ml) and large dose(1.6 g/ml) of Changrui Enemas by retention enema were given for 7 days, with the admixture liquids of Gentamyein and Dexamethasone, Xilei Powder was used as controls. Changes of IL-1β and NF-κB expression were investigated by semi-quantitative RT-PCR and IHC respectively. Results The expression of IL-1β and NF-κB were determined in the groups accepted radiation, but there had been a dramatic decline in the treatment groups(P<0.05). The high dose treatment group was superior to the low dose one on the whole. Conclusion Changrui Enemas can down-regulate the expression of inflammatory factor IL-1β and NF-κB on radiation induced proctitis rats, and reduce the inflammatory reaction, protect the rectal mucosa, accelerate healing up of the ulcer and relief the symptoms.

Objective To investigate the significance of T-bet and GATA-3 in the pathogenesis of pityriasis rosea.Methods SYBR Green Ⅰ real-time fluorescence quantitative PCR was performed to detect the expressions of T-bet and GATA-3 mRNA in peripheral blood mononuclear cells (PBMCs) from 17 patients with pityriasis rosea and 20 normal human controls.Results The average delta Ct value of T-bet mRNA and GATA-3 mRNA was 3.33 ± 0.94 and 5.22 ± 0.69 respectively in the patients,4.31 ± 1.11 and 4.36 ± 1.02respectively in the controls.There was a higher expression of T-bet mRNA but a lower expression of GATA-3 mRNA in the patients compared with the controls (both P ＜ 0.05).Conclusions Patients with pityriasis rosea show an increased ratio of T-bet to GATA3 expression and predominant expression of Th1-type cytokines.Abnormal cellular immunity may play an important role in the pathogenesis of pityriasis rosea.

PurposeTo investigate the effect of gasoline on the skin barrier function.MethodsA rat skin model in vitro was used in this study. The amount of 3H-water penetrated throught the skin was applied as the index of evaluating the barrier function.ResultsThe results showed that the amount of 3H-water was not obviously increased in those exposed to gasoline for 0.5,1 and 2 h(P > 0.05), but the 3H-water penetration amount through the skin increased linearly with the time. In the group exposed to gasoline 4 h, the 3H-water penetration amount through the skin was significantly higher than that in the control group (P 0.05). The skin barrier function of the group (expopsed to gasoline 4 h) was disrupted.Conclusions Gasoline may disrupt the skin barrier function. Gasoline would remove the lipids within the intercellular domains of the stratum corneum and then lead to damage the skin.

AIM: To study the effects of vitamins on vascular activity elements in rabbits with atherosclerosis risk factors to determine whether vitamins have a role in preventing atherosclerosis. METHODS: 26 male Chinese rabbits were randomly divided into 3 groups. The first group was fed with normal feed as control group (n=6) .The other two groups were fed with normal feed plus cholesterol, lard and methionine as model group (n=10) and vitamin treatment group (n=10) respectively. In addition, the vitamin group was given multi-vitamin daily by gastrogavage. The experiment lasted for 8 wk. The vascular activity elements of the three groups were detected by radioimmunoassay and nitrate reductase respectively ,and the aorta pathological sample was prepared. RESULTS: In model group, the levels of plasma endothelin and thromboxane B 2/6-keto-prostaglandin F l? were significantly increased compared with control group, but serum nitric oxide showed no obvious changes between both groups. In vitamin group, the levels of plasma endothelin and thromboxane B 2 were significantly decreased, and the levels of 6-keto-prostaglandin F1? and nitric oxide were significantly increased compared with model group. In model group, there were significant pathological lesions, but the lesion was decreased by vitamin treatment. CONCLUTION: The vitamins supplement can alleviate or block the impairment of vascular endothelia caused by atherosclerosis risk factors, and help adjust the equilibrium of vascular activity elements. Therefore vitamins may play a positive role in preventing atherosclerosis.

Objective To raise the level of clinical diagnosis for the patients with pituitary stalk interruption syndrome (PSIS). Methods Five patients (4 males) with PSIS were retrospectively analyzed with respects to the clinical features, endocrine status and image characteristics. Magnetic resonance imaging (MRI) scan was performed at hypothalamic-pituitary region. Results The clinical manifestations of all patients consisted of growth retardation and delayed puberty without polyuria. Deficiency of multiple anterior pituitary hormones was revealed in all patients by the evaluation of endocrine status. The features of MRI included a lack of visible pituitary stalk, absence of posterior lobe hypersignal in the sella turcica and a hyperintense spot in the region of the thalamus opticus. Conclusion The clinical characteristics of patients with PSIS are growth retardation and delayed puberty. The evaluation of anterior pituitary function is necessary. The detection of an anatomical abnormality around hypothalamic-pituitary region by MRI is important diagnostic evidence.

Objective To investigate the auditory features in patients with severe obstructive sleep apnea hy-popnea syndrome(OSAHS) and the effects of continuous positive airway pressure (CPAP) on auditory functions . Methods Pure tone audiometry thresholds ,auditory brainstem responses (ABR) and distortion product otoacoustic emissions(DPOAE) were performed in three groups with 12 observed objects in each group ,which were the OS-AHS group(before and after treatment of CPAP) ,the simple snoring group and the normal control group .Results In the OSAHS group ,the high frequency auditory thresholds(at 8000 Hz) were greatly higher and the amplitudes of DPOAE reduced ;the detection rates of DPOAE were obviously declined .The peak latencies of Ⅰ ,Ⅲ and Ⅴ , and interpeak latencies of Ⅲ - Ⅴ andⅠ - Ⅴ were longer than those of in the other two groups .The differences were statistically significant(P<0 .05) .The differences of the interpeak latencies of Ⅰ - Ⅲ ,common pure tone au-ditory thresholds (125～4000 Hz) and the thresholds of Ⅴ -wave reaction in the OSAHS group did not change sig-nificantly compared with the other two groups(P>0 .05) .The amplitudes and the detection rates of DPOAEs (0 .5～8 kHz) increased after treatment with CPAP .The differences were statistically significant except the amplitudes of 500 ,750 and 1500 Hz (P<0 .05) .Pure tone audiometry and ABRs did not changed significantly after treatment with CPAP (P> 0 .05) .Conclusion The auditory functions of patients diagnosed with severe OSAHS were im-paired .Treatments with CPAP can partly improve the patients' auditory functions .

Objective Metabolites produced by metabolic imbalance such as free fatty acids and lipopolysaccharides can result in a state of chronic low-grade inflammation, or metabolic inflammation, which plays an important role in the pathogenesis of atherosclerosis, type 2 diabetes, non-alcoholic fatty liver disease, and obesity. The above metabolic disorders are closely related with the metabolic inflammation, which always coexist. Therefore, we proposed the concept ofmetabolic inflammatory syndrome ( MIS). According to our study, patients with two or more metabolic disorders above could be diagnosed as MIS. The current research is aimed to investigate the prevalence of MIS and its components, and to compare the clinical values of MIS and metabolic syndrome ( MS) . Methods 2 001 in patients with type 2 diabetes from 6 hospitals in Shanghai were recruited in the current multi-center cross-sectional study. The diagnostic rates of MIS and MS and their components of both syndromes were compared. Results In the patients with type 2 diabetes, the detective rate of MIS was 96. 2%, which was higher than that of MS (71. 3%). Among 4 components of MIS, atherosclerosis showed the highest detective rate (75.6%). MIS[OR=2.252(95%CI1.026-4.942),P=0.043],atherosclerosis[OR=2.726(95% CI1.953-3. 804),P<0. 001], and MS[OR=1. 915 (95%CI 1. 444-2. 540),P<0. 01] were the risk factors of coronary heart disease. Conclusion With atherosclerosis, type 2 diabetes mellitus, non-alcoholic fatty liver disease, and obesity as its 4 components, MIS has a high detective rate in patients with metabolic disorders, and seems to be more sensitive than MS to distinguish inflammation-related metabolic diseases. The concept of MIS will promote the screening and prevention of atherosclerosis in its early stage.

Objective: To investigate the diagnosis and treatment for oral mucositis induced by low-dose methotrexate and to provide a reference for clinicians Methods : A case of severe chemotherapy-induced oral mucositis caused by short-term use of low-dose methotrexate (the maximum cumulative dose within 1 week) was reported and reviewed in combination with the literature. Results: The patient was treated with low-dose methotrexate (2.5 mg orally every other day at weeks 1, 2, and 4; the third week, 2.5 mg each time for 3 consecutive days for twice, with a maximum cumulativedose of 15 mg within a week). After irregular medication for approximately three weeks, the patient gradually developed severe erosion of the lips, pain, difficulty eating, and skin erosion on both legs. Methotrexate was stopped after admission, and local symptomatic treatments such as Kangfuxin solution were given. Recombinant human granulocyte colony-stimulating factor was used systemically when combined with neutropenia. After treatment, the chemotherapy-induced oral mucositis and skin lesions were improved. A literature review shows that chemotherapy-induced oral mucositis is a toxic reaction to high-dose methotrexate, while cases of severe chemotherapy-induced oral mucositis caused by low-dose methotrexate are rare. Studies have found that the more risk factors patients have, such as poor local oral conditions and systemic diseases such as liver and kidney dysfunction and diabetes, the higher the risk of chemotherapy-induced oral mucositis. Clinicians should cooperate with dentists to address oral diseases as much as possible before using chemotherapy drugs. In addition, when ordering patients to take methotrexate, we should pay attention to the patient's general condition and susceptibility factors, standardize the frequency and dose of administration, adopt personalized treatment plans, and give patients detailed medication education to prevent the occurrence of adverse consequences caused by medication errors. If methotrexate poisoning occurs, the drug should be stopped in time, detoxification and active symptomatic and supportive treatment should be given. Basic oral care, cryotherapy, laser therapy, nutritional support and analgesic drugs are common treatments for chemotherapy-induced oral mucositis. Systemic administration of granulocyte colony-stimulating factor may be considered when accompanied by neutropenia. Conclusion It is necessary to be alert to the occurrence of severe chemotherapy-induced oral mucositis caused by low-dose methotrexate in clinical practice.