Humans ; Myocardial Infarction ; physiopathology ; Ventricular Function, Left ; immunology ; Ventricular Remodeling ; immunology

A total of 126 patients with type 2 diabetes mellitus were randomized into two groups:one received glimepiride 1 mg twice daily and the other 2 mg once daily.Fasing blood glucose(BG),BG 2 h after meals(breakfast,lunch and dinner)and HbA_(IC)were tested,△and standard deviation of the 4 point BG were calculated.It was found that two kinds of administration of glimepiride were equally effective in decreasing BG and once daily aministration could ease better the fluctuation of BG.

Objective To observe the cost-effectiveness of using continuous subcutaneous insulin infusion (CS Ⅱ) and multi-point daily insulin injections (MDI) in controlling blood sugar in the newly hospitalized type 2 diabetes patients. Methods Retrospective analysis on 86 cases taking CS Ⅱ and 103 cases using MDI on a 'blood sugar control program' among the newly hospitalized patients with type 2 diabetes. The period for observation was 2 weeks, using cost-effectiveness analysis methods to evaluate the two treatment programs. Results After two weeks of treatment, the effectiveness in the control of blood sugar in CS Ⅱ group was similar to the MDI group, with no significant difference(P<0.05) and the adverse reactions were similar. Costs in the CS Ⅱ program (Yuan/person) was less than in the MDI program (1478.34 vs. 1620.46), with significant differences (P< 0.05). The cost-effectiveness ratios (C/E) were 15.07 in the CS Ⅱ group, and 16.34 in the MDI group, with no significant difference (P>0.05). In order to further reduce the cost of CS Ⅱ group as a reference, the incremental cost-effectiveness ratio (△C/ △E)ofthe MDI group was 129.20. Conclusion Costs-effective of the CS Ⅱ program was better than the MDI one in treating the newly hospitalized patients with type 2 diabetes, suggesting that CS Ⅱ program might be a better choice for hospitals to carry on an intensive insulin therapy program.

OBJECTIVETo investigate the renal protective effects of sulodexide and its anti-oxidative stress mechanism in diabetic rats.

METHODThirty male SD rats were randomized into 3 equal groups, namely the control group, diabetic group, and sulodexide treatment group. Twelve weeks after establishment of rat diabetic models and administration of sulodexide, the rats were sacrificed for measurement of the urine volume, body mass, kidney mass/body weight ratio, plasma glucose, and glycosylated hemoglobin (HbA1c). Malondialdehyde (MDA) levels and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-PX) activities in the renal tissue or serum were tested. Electron microscopy was performed to observe the pathological changes in the kidneys.

RESULTSThe urine volume, renal mass/body mass ratio, serum glucose, HbA1C, and serum and renal MDA levels all significantly increased in the diabetic rats in comparison with the normal controls (P<0.05). But the body weight and activities of SOD, CAT, and GSH-PX in the renal tissue in the normal control group were significantly higher than those in the diabetic and sulodexide group. After 12 weeks of sulodexide treatment, SOD, CAT, and GSH-PX activities in the renal tissue of rats were significantly increased in comparison with those in the diabetic rats (P<0.05). Electron microscopy showed obvious irregular thickening of the glomerular capillary basement membrane in the diabetic group with vacuolization in the mitochondria in the epithelial cells, and such pathological changes were significantly alleviated in the sulodexide treatment group.

CONCLUSIONSSulodexide can effectively lower the urinary albumin excretion rate, improve the ultrastructural renal pathologies and prevent glomerular basement membrane thickening in diabetic rats, probably in association with the reduction of the MDA levels and enhancement of SOD, CAT, and GSH-PX activities.

Animals ; Antioxidants ; pharmacology ; therapeutic use ; Body Weight ; drug effects ; Catalase ; metabolism ; Diabetes Mellitus ; drug therapy ; metabolism ; pathology ; Glutathione Peroxidase ; metabolism ; Glycosaminoglycans ; pharmacology ; therapeutic use ; Kidney ; drug effects ; metabolism ; pathology ; Male ; Malondialdehyde ; metabolism ; Organ Size ; drug effects ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

To investigate the effect of hepatitis B virus X protein(HBx) on CtBP-interacting protein(CtIP) which is an important repair factor of DNA double strand break damage in HepG2 cells induced by bleomycin. A HBx stably expressing HepG2 cell line and a control HepG2 cell line with empty vector transfected were established. After the double strand break (DSB) damage occurred, the mRNA and protein levels of CtIP were detected by Real-time PCR and Western blot assay respectively, cell cycle profiles and apoptotic cell death were determined by a flow cytometry, and the position of CtIP in cells was observed by confocal laser scanning microscopy. It showed that HepG2 cells transfected with hepatitis B virus X gene could stably express HBx protein. After being induced by bleomycin, the percentage of apoptotic cell was 16.90%+/-0.89% in HBx stably expressing HepG2 cell line and 15.30%+/-0.86% in control cell line, respectively (q = 2.074, P is more than to 0.05). While the percentage of death cell was 8.71%+/-0.74% in HBx stably expressing HepG2 cell line and 4.90%+/-0.46% in control cell line, respectively (q = 7.126, P is less than to 0.01). The two cell lines manifested the increase of G2/M arrest and significant difference existed between the two cell lines. HBx down regulated the expression levels of CtIP and its mRNA. The CtIP level was 0.66+/-0.04 in HepG2-HBx cell and 0.73+/-0.05 in HepG2-vec cell, respectively (t = 2.314, P is less than to 0.05). The relative mRNA level was 1.00+/-0.06 in HepG2-HBx cell and 1.23+/-0.08 in HepG2-vec cell, respectively (t = 2. 732, P is less than to 0.05). We also found that CtIP was concentrated in the cell nucleus. The research suggests that HBx may affect DNA-repair pathways by disrupting the expression of CtIP.
Carcinoma, Hepatocellular ; metabolism ; Hep G2 Cells ; Hepatitis B virus ; genetics ; Humans ; Liver Neoplasms ; metabolism ; Real-Time Polymerase Chain Reaction

OBJECTIVETo assess the therapeutic effects of low tension, anti-reflux Roux-y sigmoid neobladder.

METHODSA total of 21 patients (7 male and 14 female) were included, aged 43-87 years. All cases received radical cystectomy and low tension Roux-y sigmoid neobladder procedure for invasive bladder cancer were included in this study. The period of follow-up was from 8 to 79 months (the average was 36 months). Evaluations included urinary flow rate, post voiding residual and filling cystometry.

RESULTSThe mean maximum urinary flow rate, the voiding time and the post voiding residual were 28.1 ml/s (21.4-38.4 ml/s), 17 s(9-28 s) and 0 ml respectively. The cystometric capacity was 480 m1 (350-560 ml). The volume of desire to void was 330 ml (120-410 ml). The bladder pressure was from 14.2 to 18.6 cm H2O (the average bladder pressure was 16.4 cm H2O) at high filling volumes. The maximum voiding pressure was 45.0 cm H2O (23.6-63.4 cm H2O).

CONCLUSIONSThe Roux-y sigmoid neobladder has an adequate capacity at low pressure with a satisfactory continence, and it is an effective method for continent urinary diversion.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; surgery ; Colon, Sigmoid ; surgery ; Cystectomy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Urinary Bladder Neoplasms ; surgery ; Urinary Diversion ; methods ; Urodynamics

OBJECTIVE: To investigate the feasibility and safety of substituting tacrolimus(FK506) for cyclosporin A(CsA) on delaying the pace of renal dysfunction in patients with biopsy-proven chronic allograft nephropathy(CAN). METHODS: Seventy-three renal transplantation patients with CAN proved by allograft biopsy were collected in this study. Patients were randomly divided into 2 groups. Patients were either converted to FK506(FK506 group, n=43) or remained on their initial CsA-based immunosuppression(CsA group, n=30). The clinical data at study entry and after 12 months including blood urea nitrogen(BUN), serum creatinine(SCr), glomerular filtration rate(GFR), 24-hour urine protein excretion, serum total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL) and the side effects of calcineurin inhibitors were monitored during a follow-up of over 12 months. RESULTS: Twelve months later, the level of SCr was statistically reduced and GFR levels were obviously elevated in the FK506 group as compared with CsA group [(194.8+/-42.5)micromol/L vs. (245.4+/-52.8)micromol/L and (50.14+/-3.92)mL/(min.1.73 m(2)) vs. (40.58+/-2.49)mL/(min.1.73 m2), P<0.01]. Quantity of 24-hour urine protein excretion in the FK506 group was (2.0+/-0.5)g which is significantly lower than (3.9+/-0.7)g in the CsA group(P<0.01). TC, TG, and LDL levels remained unchanged in the CsA group, while those were statistically reduced in the FK506 group respectively [(5.19+/-0.73)mmol/L vs. (6.94+/-1.37)mmol/L, (1.86+/-0.84)mmol/L vs. (3.14+/-1.38)mmol/L, (3.03+/-0.71)mmol/L vs. (3.82+/-0.89)mmol/L, P<0.01]. Tremor obviously increased (P<0.01) and hypertension obviously decreased (P<0.05) in the FK506 group compared with the CsA group. CONCLUSION FK506 treatment can greatly improve the proteinuria and hyperlipidemia. Conversion from CsA to FK506 is an effective and safe alternative therapy for delaying the progression of renal dysfunction induced by CAN.
Adult ; Aged ; Cholesterol ; blood ; Creatinine ; blood ; Cyclosporine ; therapeutic use ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Graft Rejection ; complications ; Humans ; Immunosuppressive Agents ; therapeutic use ; Kidney Failure, Chronic ; blood ; drug therapy ; etiology ; Kidney Transplantation ; adverse effects ; Lipoproteins, LDL ; blood ; Male ; Middle Aged ; Tacrolimus ; therapeutic use ; Treatment Outcome ; Triglycerides ; blood

Objective To evaluate the overall prognostic effects of pregnancy-associated plasma protein-A (PAPP-A) in acute coronary syndrome (ACS)through a meta-analysis.Methods Literature was retrieved by formal searching of electronic databases (PubMed,EMBASE,OVID,Web of Knowledge,and the Cochrane Library) and by hand searching of reference lists of related articles.Random effects meta-analysis and relative risk were used to estimate the association between PAPP-A levels and adverse cardiovascular outcomes after ACS as well as preplanned subgroup analyses were conducted to identify the risk-subgroup interactions that could explain the between differences.Results A total of fourteen clinical trials were included in this Meta-analysis which involving 9413 patients.Pooled RR and their 95％ confidence intervals (CIs) for all eligible studies was 1.97 (1.49-2.60),which indicated a prognostic value of PAPP-A in patients with ACS.Differences in study design,measurement of association and duration of follow-up were responsible for the differences in results across the studies.Conclusion Our results suggested that a higher early blood PAPP-A could moderately increase the long-term risk of adverse cardiovascular outcomes and might serve as a valuable prognostic predictor in patients with ACS.

Objective:To evaluate the application value of urine cell DNA quantitative analysis in the diagnosis of urinary tract tumors.Methods:There were 92 cases of urinary tract inflammation and 39 cases of patients with suspected bladder cancer urine were tested by DNA quantitative determination, conventional cytology test and urine cytology, pathological diagnosis as the gold standard,the value of the three methods in differential diagnosis of urinary tract inflammation and bladder cancer were assessed,the correlationship between urine cell DNA quantitative and tumor types was analyzed. Results:The sensitivity and specificity of urinary DNA ploidy analysis for the diagnosis of bladder cancer were 88.89% and 97.09%,respectively,and the diagnostic accuracy was 94.66%.The sensitivity and specificity of the traditional urine cytology test were 51.85%and 100%,respectively,and the accuracy was 90.07%.The sensitivity and specificity of urine liquid based cytology test in the diagnosis of bladder cancer were 81.48% and 99.04%,respectively,and the diagnostic accuracy was 95.41%.Urine DNA ploidy analysis results >5C cell number and the type of the urinary tract epithelial cancer were associated,high level of urinary tract epithelial cancer group (>5C)cell number was significantly higher than the low level group.Conclusions:The urine DNA quantitative analysis can identify the urinary system inflammation and bladder cancer, which is better than the traditional cytology test.