Acromegaly is mostly caused by a pituitary adenoma secreting growth hormone ( GH ) , which leads to a wide range of endocrine morbidities, with an insidious onset and slow progression.A long-term overproduction of GH results in elevated insulin-like growth factor-1 ( IGF-1 ) level, which in turn, would cause target organ damage and an increased risk for mortality and decreased quality of life.Herein, the literature regarding the progress of drug therapy for acromegaly in recent five years is reviewed.

Objective To observe the curative effect of acupuncture on insulin receptor substrate 1 ( IRS-1) , IRS-2 and glucose transporter 4 (GLUT4) in skeletal muscle of experimental rats with insulin resistance (IR) . Methods Thirty-two rats were randomly divided into normal group, model group, acupuncture normal group and acupuncture model group. The fasting plasma glucose ( FPG) level was detected with glucose oxidase method, fasting insulin and C-peptide ( C-P) were examined with enzyme linked immunosorbent assay ( ELISA) , insulin sensitivity index ( ISI) was calculated, and IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA of skeletal muscle were observed by real-time PCR-based fluorescent assay in each group. Results Compared to the normal group, the FPG, FINS, C-P levels were increased dramatically (P<0.01), ISI, IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA of the model group declined remarkably ( P<0.01). Compared to the model group, the FPG, FINS, C-P levels declined evidently ( P<0.05 or P<0.01) , and ISI, IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA of the acupuncture model group were increased dramatically ( P<0.01). Conclusion The curative mechanism of acupuncture for insulin resistance is probably related to the increase of IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA expression in skeletal muscle which contributes to the improvement of PI3K signal pathway.

Objective:To study the content in the new version of EU-GMP ANNEX 15 (draft) to find the changes of the new and the old version and help the domestic pharmaceutical enterprises meet the requirements of the EU-GMP and complete verification and validation activities.Methods:The new version and the old version of EU-GMP ANNEX 15 were compared,and the changes in the new ANNEX 15 were analyzed in order to understand the changes deeply.Combined with the current implementation status of verification and validation activities in domestic pharmaceutical enterprises,some suggestions on qualification and validation work were provided for domestic pharmaceutical enterprises.Results and Conclusion:The new revision of EU-GMP ANNEX 15 (draft) emphasizes qualification and validation activities during the life cycle of products,and processes,and risk management methods should be used in qualification and validation activities.

Child ; Ear, External ; Foreign Bodies ; surgery ; Humans ; Labyrinth Diseases ; etiology ; Male ; Postoperative Complications

Humans ; Labyrinth Diseases ; pathology ; therapy

Objective To investigate surgical techniques and results of arthroscopic reduction and fixation for the treatment of avulsion fracture of the posterior cruciate ligament from the tibia through an additional posterolateral portal. Methods An additional posterolateral portal was established by using the inside-out technique under arthroscopic view.After a protective sleeve was placed through the portal and the displaced fracture was reduced,the fragment was fixed by the guide wire drilled through the sleeve temporarily.If the fluoroscopic control showed an anatomic reduction of the fragment and good placement of the wire,the self-attacked cannulated screw and washer was placed intra-articularly over the guide wire through the sleeve for the directive internal fixation of the avulsion fracture.Aggressive rehabilitation programs were recommended postoperatively.Results Except 1 case with 11 mm displacement and rotation of the fragment treated by the arthrotomy after the failure of arthroscopic reduction,the arthroscopic operation was accomplished in all the remaining 10 cases.The operative time was 63～98 min(mean,87.3 min).No injuries of popliteal vessels or nerves occurred.The postoperative X-ray firms showed an anatomic reduction of the fragment and good placement of the screw and washer.With the negative posterior drawer test confirmed by the physical examination,normal range of motion of the injured knee joint and gait were achieved in the 10 patients at 4～7 weeks after surgery.The bone union was confirmed by X-ray films at the 3 months postoperatively.The computer KT-2000 arthrometer measurements of posterior tibial displacement of both knee joints showed side-to-side difference not more than 1.2 mm in 6 patients at 5 months after surgery.Conclusions The additional posterolateral portal can be established by the arthroscopic inside-out technique safely.The displaced fragment of the avulsion fracture of the posterior cruciate ligament from the tibia can be reduced and fixed with the self-attacked cannulated screw and washer arthroscopicly.

Objective To explore the clinical features of systemic onset of juvenile idiopathic arthritis (SoJIA) with atlantoaxial subluxation as the initial manifestation. Methods The clinical data from one SoJIA patient with atlantoaxial subluxation as the initial manifestation were retrospectively analyzed. Results A 9-year-old boy presented the head and neck movement disorder as the ifrst symptom, developed fever on the third day, then rapidly progressed on 23rd day, with a sharp decline in red blood cell, platelet, and hemoglobin, blood coagulation dysfunction, and a large number of bilateral pulmonary exudation. Ultrasonography showed excess lfuid in abdomen, chest, and pericardium. According to the 2001 version of the revised International College of Rheumatology standard, the diagnosis of SoJIA combined macrophage activation syndrome was conifrmed. Then treated with hemoperfusion, ifltration, and methylprednisolone combined with cyclosporine A, the disease was in remission. Conclusion For children with spontaneous atlantoaxial subluxation accompanied by the systemic symptoms, with no obvious skeletal deformity or acute inlfammation etc., should be alerted to the consideration of systemic juvenile idiopathic arthritis.

Donguibogam was introduced from traditional Chinese medicine (TCM) instead of the local representa-tive work of the Democratic People's Republic of Korea (DPRK). It is also the concrete manifestation of theories of different schools of doctors according to Dr. Xu Jun's medical thoughts. In this paper, from Dr. Xu's advocacy to Taoism and the concept of aftercare spirit, the exploration was made on health cultivation for different body constitu-tions. According to the health cultivation effects of the medicinals and edible food, the focus was made on the sys-tematic collation and induction of more than 1 400 kinds of herbs contained in the soup liquid from papers in three volumes. The medicinals were divided into eight categories, which were benefiting qi, nourishing yin, tonifying yang, clearing heat and promoting dieresis, drying dampness and resolving phlegm, promoting blood circulation for remov-ing blood stasis, dispersing stagnated liver qi, nourishing blood for hemostasis. Donguibogam specified the health cultivation concept from the correspondence between the body constitution and the medicinal performance. It has a certain guiding significance to the current health cultivation.

Objective In order to study the difference of depression-like behaviours among three widelyused stress models in rats.Methods The new-born Spragne-Dawley rats were randomly divided into maternal deprivation(MD) group(n=27),chronic mild stress(CMS) group (n=29),dual stress(DS) group ( n=31 ) and control (C) group ( n =30) on postnatal day 1.MD rats only received maternal deprivation.CMS rats only received chronic mild stress when 10 weeks old.DS rats received both maternal deprivation and chronic mild stress.Control rats received no experimental handling.Behavior tests including forced swimming test and sucrose consumption which were carried out to evaluate rats' depression-like behaviors in the thirteenth weeks.The extend time of floating and sucrose preference ratio should be recorded in the forced swimming test and sucrose consumption test respectively to reflect the behavior of helplessness and anhedonia of rats.Results In the forced swimming test,the extend floating time of MD group( 119.30 ± 65.56) s,CMS group ( 145.00 ± 80.24) s and DS group ( 170.03 ±61.75 )s were longer than the control group(81.14 ± 52.40)s (F =11.53,P ＜ 0.01 ).In the sucrose consumption test,the MD group(0.32 ± 0.22) had a low sucrose consumption.The comparison of the MD group and CMS group (0.43 ± 0.28 ) to the control group (0.54 ± 0.28 ) had significant differences (F =4.33,P ＜ 0.01 ).In these four groups,no sexual difference was found in the forced swimming test and sucrose consumption test ( all P ＞ 0.05 ).Conclusion The results suggest that MD,CMS and DS may induce some kind of depression-like behaviors in rodents such as anhedonia or the behavior of helplessness and the depression-like behaviors induced by different stresses are similar in male and female individuals.

Objective Analyzing the regional distribution discrepancy of medical and health resources in China,with the purpose of providing the government with policy making evidences for optimizing medical and health resource allocation.Results Dividing China into three regions based on regional economic development and geographic setting,and selecting 6 indicators for medical and health resources.On the basis of the statistics of 31 provinces released by the state in 2009,analyzing the interprovincial disparities of the distribution of these six resources,by means of the coefficient of variation,Gini coefficient and Theil index.Methods The largest inter-regional allocation disparity is found in the number of biopharmaceutical manufacturing companies per ten thousand population.And the smallest discrepancy is found in the number of hospital beds among these regions.The top two extreme differences of resource possession per ten thousand population between the maximum and the minmum region are the number of biopharmaceutical manufacturing companies and tertiary hospitals.The eastern region is the largest contributor to the discrepancy of allocation for the six resources within and between regions.The less developed regions contribute the most inter-regional discrepancy for the allocation of medical practitioners(their assistants included),hospital beds,tertiary hospitals and pharmaceutical companies.And the developed regions contribute the most inter-regional discrepancy of medical finance support from local governments and the most of the allocation of biopharmaceutical manufacturing companies.In general,regions of higher development enjoy greater possession of the SIX resources per population in such regions. But these two are not always in direct proportion. Condnsion Regional distribution disparity of the six resources is not yetreasonable in China.To better meet the health needs of the population in various regions,the government is expected to increase its financial support for building biopharmaceutical manufacturing companies and tertiary hospitals in the less developed western regions,to better use resources of developed regions,and to keep off investments at low level and repetition.The government is also recommended to pay attention to the proportion of government health finance output and the quality and quantity of medical practitioners.