OBJECTIVE:To analyze clinical efficacy and safety of pioglitazone combined with metformin in the treatment of type 2 diabetes.METHODS:102 patients with type 2 diabetes were randomly divided into 2 groups.Treatment group received pioglitazone combined with metformin and treatment group received metformin alone.The levels of blood glucose and insulin were observed and compared between 2 groups.RESULTS:After 6 months of treatment,fasting plasma glucose(FPG),postprandial 2 h blood glucose(P2hBG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),postprandial 2 h insulin(P2hINS),steady-state assessment index of insulin(HOMA-IR) in 2 groups were significantly decreased,there was statistical significance in difference before and after treatment(P

Objective To investigate the effects of single and combined exposure to ozone and nitrogen dioxide on airway injury and inflammatory levels in mice. Methods Eighty BALB/C mice were randomly divided into eight groups:four were sensitized model groups(the control group,the O3 group,the NO2 group and the O3+NO2 group based on the way of exposure) ,the other four were non-sensitized groups. The concentration of O3 was 0.16 mg/m3,NO2 was 0.30 mg/m3. Mice were exposed 2 hours every day for 7 consecutive days. Mice were sacrificed in the exposure end and cell counting and cytokine measurement from bronchoalveolar lavage fluid(BALF) were performed. Results In the sensitized groups,neutrophil proportion and IL-6 were significantly increased except the control group and IL-2 and MDA were also significantly increased in the O3 group and the O3+NO2 group(P

This article was aimed to study the inhibition of cell proliferation and induction of apoptosis by β-el-emene extract from traditional Chinese medicine (TCM) Rhizoma Zedoariae on human hepatocellular carcinoma (HepG2) cells, as well as the effect on expression of apoptosis-related proteins in liver cancer-burdened H22 mice. Human HepG2 cells were cultured in vitro. MTT method was used in the determination of β-elemene on cell prolif-eration. Apoptosis of cells were detected by the Annexin V-FITC/PI double staining method. Through the establish-ment of liver cancer-burdened H22 mice model, the inhibition of cell proliferation and induction of apoptosis-related protein expression by β-elemene on tumor-burdened mice were observed. The results showed that β-elemene inhib-ited HepG2 cell proliferation, which was dose- and time-dependent. Annexin V-FITC/PI method detected early apoptotic cells. Inhibitions of tumor growth on tumor-burdened mice from different groups were different. Inhibition of tumor growth in the high-dose β-elemene group was relatively low, and that of the middle-dose was more obvi-ous. It was concluded that β-elemene can effectively inhibit human HepG2 cells proliferation. The inhibition on pro-liferation of cancer cells was through the inducing of cell apoptosis. It was also related to the upregulation of apopto-sis-related protein Caspase-3 and downregulation of NF-κB P65.

Objective To explore the proportion of different types of stones in patients with kidney stones in Xinjiang, and to analyze the relationship between stone composition and urine physicochemical properties and protein composition.Methods Through a case-control study, 355 patients with kidney stones who were hospitalized in the Xinjiang Uygur Autonomous Region People′s Hospital from March to November 2010 were enrolled in the same period, and non-urinary tract diseases were hospitalized and excluded from other diseases or complications of the 30 cases of renal impairment in the control group.The composition of the stones was analyzed.The main components of the stones were divided into oxalate group, carbonic acid group, uric acid group and phosphate group.The physicochemical properties and protein composition of 24 h urine were analyzed by ion selective electrode method, enzymatic and immunoturbidimetric assay.The difference between the two samples was analyzed by t test, and the differences between the two groups were analyzed by F-test and LSD-t test.Results Compared with the control group(30 cases), urine pH(5.33±0.32) was significantly lower in the oxalate group (244 cases), 24 h urinary calcium and 24 h uric acid[(7.68±0.35) mmol, (3.48±0.23)mmol (pH=5.874,P<0.05)].The urine pH (6.98±0.77) was increased in the phosphate group (23 cases), and the 24 h urinary magnesium (3.02±0.29) mmol was significantly lower than in the control group (10.56±0.63) mmol, and the level of 24 h urinary calcium (7.96±0.569) mmol increased (t>9.436, P<0.05).There were 23 patients with calcineuria (P<0.05).The urine pH level in the uric acid group (61 cases) was as low as (4.97±0.48), and 49 patients were accompanied by excessive acidification (80.3%) and 24 h uric acid (4.14±0.37) mmol (t=11.459,P<0.05).And the urine pH (6.86±0.68) was higher in the phosphate group (n=23) (t=6.876,P<0.05).In addition, urinary Cystatin C (0.653±0.148)mg/L, urinary α1-microglobulin (1.53±0.56)mg/dl and urinary β2-microglobulin (0.585±0.088)mg/L in the oxalate group (t>8.442,P<0.05).Conclusion There may be a correlation between renal stone composition with urine metabolic changes.

Objective To assess the value of exercise treadmill testing (bruce protocol) in diagnosing early atherosclerotic lesions of the lower limb. Methods Between March and September 2008, 173 outpatients with high risks of peripheral arterial disease (PAD) were enrolled randomly from the cardiology clinic of Chinese PLA General Hospital. The patients were subjected to exercise treadmill testing (Bruce protocol) and ankle-brachial index (ABI) determination, as well as lower limb artery ultrasonography within one week. Using ultrasonic findings as diagnostic criteria, the diagnostic sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of exercise treadmill testing for early atherosclerotic lesions of the lower limb were analyzed, and the diagnostic value of exercise treadmill testing was assessed using the ROC curve. Results After exercise, ABI decrement (R value) increased in subjects with high risks for PAD with atherosclerotic lesions of the lower limb aggravating. Using the presence of large atherosclerotic plaques (area > 20 mm2 ), atherosclerotic plaques and atherosclerotic lesions in lower limb arteries as positive diagnostic criteria, the area under curve of ROC was 0. 80 (95% CI: 0.72-0.88), 0.78 (95% CI: 0.71-0.85) and 0. 60 (95% CI: 0.44-0.76), respectively. Using the presence of large atherosclerotic plaques in lower extremities as positive diagnosis, R value was 0.80, with a sensitivity of 54. 0%, a specificity of 96. 7%, a LR+ of 16. 4, and a LR- of 0. 58, meanwhile, R value was 0. 85, with a sensitivity of 70.0%, a specificity of 91.9%, a LR + of 8.64, and a LR- of 0.33. Conclusions Exercise treadmill testing (Bruce protocol) in combination with ABI determination is a safe, accurate, objective tool for detecting early atherosclerotic lesions of the lower limb. Immediately after exercise, 0.85 is the cut-off R value appropriate for diagnosing large atherosclerotic plaques of the lower limb (area > 20 mm2).

AIM: To investigate the changes of expression of calcium-sensing receptor(CaSR) in the rat cardiac tissue at different age and its relation with anoxia-reperfusion(A/R) injury.METHODS: RT-PCR was used to detect the mRNA expression of CaSR.The A/R injury was remodeled in vitro,and the ultrastructure of cardiac tissue was observed under transmission electron microscope.RESULTS: The expression of CaSR mRNA in the rat cardiac tissue increased gradually after birth,and reached to its maximum in the 1st month.In the 2nd to 3rd month,the expression were almost equal to that at birth and then increased again to a higher level.The expression level of CaSR mRNA increased more significantly than those in control groups after 40 min of anoxia and reperfusion of 1 h and 2 h, and decreased after 3 h and 4 h.Moreover,the longer the reperfusion time lasted,the more serious the changes of ultrastructure were observed.CONCLUSION: Our results demonstrate that the CaSR is expressed in the rat cardiac tissue.The mRNA expression of CaSR changes with age and is involved in the anoxia-reperfusion injury.

Objective Previous investigations suggest that severe acute pancreatitis (SAP) is one of the main causes of intra-ahdominal pressure (lAP) increase. The aims of this study were, to evaluate the increased IAP in patients with SAP and the correlation between LAP and severity or prognosis. Method Data of 75 SAP patients admitted to Xuan-Wu Hospital of Capital Medical University intensive care unit with SAP from January 2000 to Jan-uary 2008 were collected. All the patients had at least one organ dysfunction, and they were diagnozed with en-hanced CT, lAP were monitored in the 56 patients. The 56 patients were divided into three groups according to IAP, group A (7- 15 mmHg), group B (16-25 mmHg) and group C (26-31 mmHg). Maximal APECHE Ⅱscore, maximal Ranson score, maximal C-response protein (CRP), maximal arterial lactate, maximal creatinine, organ dysfunction, length of stay and mortality were compared. Results The 56 patients (24 male and 32 female)with average age of (52±14.1) years (ranging 21 - 72 years) and average body mass index (BMI) of 28±12.5(ranging 21 - 35) were monitored with IAP. The etiologic causes of SAP were biliary in 27 patients, alcohol in 14cases, hyperlipidemia in 11 cases and idiopathic in 4 cases. The rate of intra-abdominal hypertension was 89% (50/56), and 32% (18/56) patients complicated with abdominal compartment syndrome. There were 22, 26 and 8 patients in the A, B and C groups respectively. With the increasing of IAP, the maximal APACHE Ⅱ, maximal Ranson score, maximal CRP, maximal creatinine, organ dysfunction and mortality were also increased significant-ly. The mortality of the three groups was 13.6% (3/22), 23.1% (6/26) and 62.5% (5/8) respectively (χ2 =7.56, p = 0.023), and the total mortality of the 56 patients was 25%. The hospital stay of the three groups had no significant differenee(F = 2.23,P = 0.117). Conclusions IAP may be one of the markers used to evaluate the severity of SAP, and the monitoring of IAP is useful to assess the prognosis in patients with SAP.

Bacterial Typing Techniques ; Genotype ; Minisatellite Repeats ; Plague ; Yersinia pestis ; genetics

Objective To type Yersinia pestis isolated from Gansu Province,and to study the trend of diffreent strains in different administrative regions and different years.Methods Totally 193 strains were enrolled in this study,including 9 strains of Ganning Dauricus type,18 strains of Aerjin type,45 strains of Qilian type and 121 strains of Qingzang type.These strains were genotyped by clustered regularly interspaced short palindromic repeats (CRISPR),and genotypes were named according to international standard.Genotyping by CRISPR in different administrative regions and different years of Gansu Province was explored.Results Two clusters (Ca7 and Cb4),including four genotypes (genotypes 7,22,24 and 26) were classified by CRISPR.From the point of view of origin,genotype 24 was the main genotype in Akesai 36.36％ (16/44),Subei 36.17％ (17/47),Yumen 50.00％ (5/10) and Su'nan 38.67％ (29/75);the main genotype of Xiahe and Huining was genotype 26 (4/7);the main genotype of Shandan was genotype 22 (1/1).From the point of view of time,the main genotype of Yersiniapestis in Gansu Province during the years of 1960-1969,1970-1979 and 1980-1989 was genotype 26 [53.33％ (8/15),60.00％ (6/10) and 48.28％ (14/29)];the main genotype was genotype 22 [40.91％ (18/44)] during the years of 1990-1999;and the main genotype was genotype 24 [43.16％ (41/95)] during the years of 2000-2009.Conclusion Four genotypes of Yersiniapestis in Gansu Province are quite different in different administrative regions and different years.