Objective To evaluate the therapeutic effect and safety of insulin lispro mix 50/50 combined with mefformin in newly diagnosed overweight/obese type 2 diabetic mellitus patients.Methods Sixty-two patients with newly diagnosed overweight/obsess type 2 diabetic mellitus were randomly divided into observation group (32 cases) and control group (30 cases) by systematic sampling method.The observation group received insulin lispro mix 50/50 combined with metformin,and the control group received recombinant human insulin and insulin glargine.The therapeutic effect and safety were compared between the 2 groups.Results There were no statistical differences in the blood glucose before eating,before retiring and at mane primo 3:00 between the 2 groups (P ＞ 0.05).There were no statistical differences in the time of blood glucose standard and rate of hypoglycaemia between the 2 groups (P ＞ 0.05).Daily insulin dosage and costs in the observation group were lower than those in the control group [(0.6 ± 0.1) U/kg vs.(0.8 ± 0.1) U/kg and (15.8 ±2.1) yuan/d vs.(21.3 ±2.6) yuan/d],and there were statistical differences (P ＜0.05).Conclusion Insulin lispro mix 50/50 combined with mefformin provides a convenient,effective and safe therapy for newly diagnosed overweight/obese type 2 diabetic mellitus patients and high cost performance.

Objective To observe the clinical effect by using insulin detemir therapy in children and adolescents with type 1 diabetes mellitus(T1DM).Methods Thirty children and adolescents with T1DM were divided into 2 groups to receive Humulin R and Determir(observation group,n =15) or Humulin R and neutral protamine hagedorn (NPH) (control group,n =15)insulin therapy.Daily insulin dose,glycemic variability,incidence of non-severe and severe hypoglycemia events after the institution of insulin therapy were collected.Results The daily doses of insulin were (1.16 ± 0.30) U/kg in the observation group and(1.21 ± 0.35) U/kg in the control group,respectively.There was no clinically important change between 2 groups(t =0.526,P ＞ 0.05).Within-subject variation in fasting plasma glucose was significantly lower in observation group(29％)than that in control group(65％) (t =5.296,P ＜0.01).One case of severe hypoglycemia event occurred in the observation group,but 5 cases occurred in the control group(t =4.863,P ＜ 0.0l).Two cases of nocturnal hypoglycaemia(22:00-7:00) events occurred in the observation group,7 cases occurred in the control group(t =4.506,P ＜ 0.01).Conclusions Institution of insulin detemir therapy is associated with low within-subject variation in fasting plasma glucose and decreased rates of severe and nocturnal hypoglycemia while dose of insulin did not increase.This makes insulin detemir a valuable new tool for the treatment of children and adolescents with T1 DM.

Objective To compare effects of compound Xueshuantong capsule and benazepril on inflammatory cyto-kines in type 2 diabetic patients with early diabetic nephropathy (DN), and its therapeutic mechanism thereof. Methods Ninety-four patients with type 2 diabetes were divided into diabetes without albuminuria group (DM,n=24) and early DN group (DN,n=70). DN group was then divided into three subgroups:group A (n=24) treated by benazepril alone, group B (n=22) treated by compound Xueshuantong capsule and group C (n=24) treated by compound Xueshuantong capsule combined with benazepril for 3 months. Levels of fasting blood glucose, glycosylated hemoglobin, serum creatinine, blood urea nitro-gen, lipid profiles, fibrinogen and urinary albumin excretion rate (UAER) were examined before and after treatment. The se-rum levels of hypersensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) were determined as well. Results The serum levels of hs-CRP, IL-6 and TNF-αwere significantly higher in DN group than those of DM group (P<0.01). After treatment, the serum levels of UAER, hs-CRP, IL-6 and TNF-αwere significantly re-duced in groups A, B and C compared with those before treatment (P<0.01), and which were decreased more significantly in group C. The levels of blood lipids and fibrinogen decreased obviously in group C compared with those of group A and B ( P<0.01). Conclusion Compound Xueshuantong capsule combined with benazepril not only can improve the blood fat and high coagulation state in patients, but also impossibly retard the development of early DN through decreasing serum concen-trations of hs-CRP, IL-6 and TNF-αand inhibiting inflammatory reaction.

Objective To investigate the influence of retinoic acid (RA) in differentiation,maturation and function of intestinal dendritic cells (DC),and probe into the effect of Vitamin A (VA) on intestinal mucosal immunity and pathway. Method Rat intestinal mucosa was cultured in vitro,supplemented with all-trans RA and/or retinoid acid receptor ? (RAR?) antagonist (Ro 41-5253). After cultured for 24h and 48h,the surface markers OX62、OX6 and CD86 on DCs were detected by flow cytometry,to observe the effect of RA on differentiation and maturation of DC. The cytokines and RAR? were measured in mRNA levels by RT-PCR to analyze the influence of RA on mucosal immunity and the pathway. Results RA promoted the maturation of DC in mucosa cultured in vitro,and up-regulated RAR? mRNA levels,the changes were marked at 24h. Moreover,when RA was present in the culture,IL-12 and IFN-? (Th1 cytokine) mRNA were reduced,and IL-10 was increased significantly compared with control . However,the actions of RA above can be inversed by Ro 41-5253. Conclusion The modulation of RA on DC could be one of the important mechanisms that VA influences intestinal mucosal immunity. RAR? participates in the regulation of RA on DC.

[Objective]To discuss the efficacy of medial wedged proximal tibial osteotomy for treating genu varus deformity.[Methods]From July 1998 to October 2007,49 patients with genu varus deformity were treated by medial wedged proximal tibial osteotomy combined with internal fixation.Full-length anterior-posterior radiographs were taken preoperatively at 8 weeks and 1.5 years postoperatively.The parameters including the femorotibial angle and the medial joint space were measured on the radiographs.The pre-and postoperative function of knee were evaluated according to the HSS score system of the knee.[Results]All the 49 patients were followed up from 18 to 128 months.The mean postoperative femorotibial angle decreaced from 187.5??5.3? to 172.6??3.6?.The mean postoperative HSS score significantly improved from 83.2?15.3 to 47.2?17.6 points after 1.5 years of operation.The medial joint space increased from(2.4?1.2) mm to(4.3?1.2) mm.There were complications in 5 cases: 3 cases of intra-articular fracture during operation and 2 of postoperative superficial wound infections.There were no delayed union,no recurrence of varus deformity,and no blood vessels or nerves injury in all cases.The pain relieved and walking function improved significantly postoperativly.[Conclusion]Medial wedged proximal tibial osteotomy combined with internal fixation is an effect approach to treat genu varus deformity.

Objective To explore the serum level of gentamycin for orally in children with serious illness.Methods The serum level of gentamycin in 41 children who were in serious illness [multiple organ dysfunction(MODS)group with 21 cases and non-MODS group with 20 cases ] were monitored and the patients were treated with select decontamination of the digestive tract(SDD) from October 2004 to April 2005.Dosage:10 mg/(kg?d),orally taken three times(every 8 hours) one day.The blood after taking the drug one hour later in the fourth day was selected and the serum level of getamycin was monitored.Results Thirty-six children of 41 cases serum level of gentamycin were negative and 5 children(4 in MODS group and 1 in non-MODS group) who had alimentary tract hemorrhage were masccline in serum after taking gentamycin one hour later in the forth day.The absorption of gentamycin from enteric after orally was not(rela)-ted to MODS.There were statistics value between the gestrintestinal tract ulcer and serum level of gentamycin.Conclusions The safety for treating the children in serious illness with gentamycin for SDD is obvious.But we suggest to monitor the serum level of gentamycin for who has severe alimentary tract hemorrhage together with insufficiency of liver and kindey.

Based on the anatomical study of kidney in mammals of 27 families and 163 species, the authors discovered Anoa depressicornis type kidney, and obtained the evidence of morphological transition between Ox-type kidney and Pig-type kidney. After observing the renal papillary structure of Budorcas taxicolor, the evidence of fact and theoretical bases of the biological view was proved that the general papillae are developed from the multi-papillae kidney. The author advanced a new type of leaf-shaped multipapillae kidney. The authors suggest to classify the mammalian kidneys principally into 2 groups, i. e, simple and composite kidney, and subdivide them into 4 types, i. e, multipapillae and concentrated papillae for simple kidney and leaf-shaped multipapillae and ball-shaped mono-papillae for composite kidney. In contrast to the previous classification, the 2-group 4-type classification recommended here with its solid anatomical foundation is conformable with the viewpoint of biology, and is more practical and integrated.

Objective To explore the protective effect of selenium, an antioxidant, on fluoride-induced renal injury in rats and find out the optimal level of selenium against fluoride toxicity and its valid molecular target.Methods All 80 male weanling SD rats were randomly divided into 8 groups by body weight as follows: normal control group(drinking tap water), fluoride exposed group (drinking water containing 50 mg/L of NaF), low, middle,high selenium exposed groups(drinking water containing 0.375, 0.750, 1.500 mg/L of Na2SeO3) and low, middle,high Se-fluoride groups (drinking water containing both 50 mg/L NaF and three doses of Na2SeO3 as abovementioned, respectively). After 6 months, the rats were killed then the oxidation level and nuclear factor κB(NF-κB)expression level in kidney were measured. Results The weight of the fluoride exposed group[(695.95 ± 55.89 )g]was significantly deceased than the controls[(782.69 ± 56.12)g, P ＜ 0.01]. Glutathione peroxidase(GSH-Px)activity of fluoride exposed group[(55.86 ± 5.09)U/mgprot] was not significantly different but decreased. Tatal antioxidant capacity (T-AOC) activity in fluoride exposed group [(7.54 ± 1.35)U/mgprot] significantly decreased than the controls[(9.03 ± 0.37 )U/mgprot, P ＜ 0.05]. In addition, a significant increase of malondialdehyde ( MDA )in fluoride exposed group[(3.86 ± 0.31 )mnol/mgprot, P ＜ 0.05] was observed than the controls[(3.14 ± 0.32)nmol/mgprot, P ＜ 0.05]. GSH-Px activity of high Se-fluoride group[(74.99 ± 8.41 )U/mgprot] was significantly higher than the fluoride exposed group[(55.86 ± 5.09)U/mgprot, P ＜ 0.05] and its MDA level[(3.17 ± 0.20)nmol/mgprot] was lower than the fluoride exposed group[(3.86 ± 0.31 ) nmol/mgprot, P ＜ 0.05]. NF-κB expression levels of fluoride group, high selenium group and low Se-fluoride group(0.360 ± 0.015,0.367 ± 0.007,0.376 ± 0.006,respecyively) were obviously increased compared with the controls(0.312 ± 0.022, P ＜ 0.05); it was significantly lower in high Se-fluoride group(0.312 ± 0.005) than in fluoride exposed group(0.360 ± 0.015, P ＜ 0.05). Conclusions Na2SeO3 of 1.5 mg/L is the optimal dose against chronic fluorosis on kidney injury under this experimental condition.NF-κB is likely to be a target molecule of the selenium as an antagonist on fluorosis.

Objective Retinoic acid receptor(RAR?) selective antagonist,Ro41-5253(Ro) was used in the counteract test,to confirm the role of RAR? in enhancement of IgM synthesis in cord blood lymphocytes(CBLs) by retinoic acid(RA).Methods CBLs were cultured in vitro and stimulated with or without RAR? agonist RA and(or) antagonist Ro.The cells were harvested at 24 hours and 48 hours of culture time to measure the levels of gene expression of RARa,IL-4 and IL-6.ELISA was used to measure the concentration of IgM in the supernatant of 5 days culture.Results Ro could inhibit the promotion of RA on IgM synthesis in CBLs.RA could up-(regulate) RAR? gene expression,which could be restrained by Ro.Ro also could counteract the up-regulation of RA on IL-4 and IL-6 gene expression.Conclusion The effect of RA on IgM synthesis in CBLs is modulated by RAR?.

A rapid and sensitive method based on biotin-avidin mediated competitive enzyme-linked immu nosorbent assay(BA-ELISA) was established for the determination of ketamine.The optimal concentration of coated antigen and anti-ketamine monoclonal antibody were found to be 2.0 and 10.2 mg/L.The concentra tions of biotinylated goat anti-mouse IgG(Biotin-IgG) and streptavidin-horseradish peroxidase(SA-HRP) were optimized and the optimum results were found to be 0.29 and 1.0 mg/L, respectively.The linear range of the presented method was from 0.1 to 1000 μg/L, and the limit of detection was found to be 0.03 μg/L.The recoveries of ketamine spiked in human serum and urine were between 94% and 102%.Comparing the result of traditional ELISA, the present BA-ELISA method had a lower detection limit for ketamine.The experimental results indicated that the present BA-ELISA method was specific and sensitive.