Objeetive To explore the relationship among the glomerular mesangium components,degree of renal lesion and glomerulosclerosis in patients with type 2 DM.Method A quantitative study of type Ⅳ collagen in kidneys taken from twenty-one patients with type 2 DM and ten-two control autoptical renal tissue specimens were investigated by immunochemical techniques,computer image analysis system.Results The amounts of type Ⅳ collagen were increased parallel with advances of glomerulosclerosis and renal arteriolosclerosis in patients with type 2 DM,but the collagen had not obviously elevation in renal failure patients.Conclusions The increased type Ⅳ collagen is a characteristic manifestation of early and moderate lesions of glomerulosclerosis in type 2 DM.Quantitative determination of glomerular mesangium components could be a good index to judge the lesion degree of kidney.

Objective To investigate the cause of high cardiovascular lethality in patients with diabetics mellitus. Methods Sections from autopsied coronary arteries and myocardium of dead patients with non-insulin-dependent diabetics mellitus and 12 dead control subjects were used for histomorphometric studies. Results The coronary atherosclerotic lesion in diabetics patients was not different in severity from those in controls. Nor was there difference in number of myofibers or diameters of myocardic fibers and capillaries.But the capillary density and the ratio of capillary number to myocardic fiber number in diabetics group were significeantly reduced compared with control group(P<0.0 l),and the capillary basement membrane in the former was significantly thicker than in the latter(P<0.01).Conclision The decrease in number of capillaries and the thickening of basement membrane enhance myocardiac vulnerability to further ischemia and hypoxia,which may undelie high lethality of myocardiopathy in diabetic patients.

Objective To observe the efficacy and safety of trimetazidine/coenzyme Q10 combination in the treatment of the elderly patients with chronic heart failure(CHF).Methods Sixty-two male patients aged over 80 years with CHF were randomly divided into intervention group and control group.Patients in control group received optimal conventional CHF therapy according to the guideline for CHF,while patients in intervention group received trimetazidine of 20 mg,3 times per day,coenzyme Q10 20 mg,3 times per day,additionally for 6 weeks.Left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),plasma brain natriuretic peptide (BNP),6 min walking distance (6MWT) and NYHA cardiac function classification of two groups before and after treatment were observed.Results Before treatmen,the NYHA function class of patients in intervention and control groups were 2.8±0.7,2.7±0.7 respectively,after treatment were 2.1± 0.6,2.4 ± 0.7 respectively,the differences were significant before and after treatment (t=6.808,2.249;P＜0.01,P＜0.05).Before treatment,BNP of intervention and control groups were (540±351)ng/L,(483 ± 351) ng/L respectively,after treatment were (219± 172) ng/L,(316 ± 202) ng/L respectively,the differences were significant before and after treatment (Z =-4.927,-4.042;P ＜ 0.01).Moreover,after treatment,NYHA function class and plasma BNP in intervention group were significantly better than those in control group (t =-2.109,P ＜ 0.05;Z =-2.219,P ＜ 0.05).Before treatment,LVEF,LVEDD and 6MWT of intervention group were (44.3 ± 3.1) ％,(54.0 ± 4.7) mm and (217.0 ± 60.9) m respectively,after treatment were (46.8±3.9) ％,(53.2±4.3) mm and (267.0±91.1) m respectively,the differences were significant before and after treatment(t=-8.313,2.254,-4.561;P＜0.01 or P＜0.05).Moreover,after treatment,LVEF and 6MWT in intervention group were significantly better than those in control group ((44.9± 3.5)％,(213.2 ±78.1) m;t =2.000,2.186;P ＜ 0.05).No significant adverse events were detected in the intervention group.Conclusion Combination of trimetazidine and coenzyme Q10 on the basis of the conventional treatment in the elderly with CHF,can further improve cardiac dysfunction and have a good safety.

Directing at the cultivating aims of the students in major of basic medical science,the article expounds some instruction innovations in teaching pharmacology.We introduce some social practical problems and some research fields which evolve rapidly to the teaching class by compiling the teaching materials,conducting lectures and giving discussion lessons.In addition,we incorporate the cultivation of students' capability of doing scientific research to the teaching work through guiding them how to read references,directing them to finish independently the project of experiment designed by themselves and operating group activities instructed by their supervisors in the department of pharmacology.

Objective To study the role of IL 12 and IL 13 mRNA in children with asthma. Methods Use of semi quantitative RT PCR, IL 12 and IL 13 mRNA in peripheral blood mononuclear cell (PBMC), as well as total IgE in serum from children with asthma, which is in the period of acute phase, were detected. Results Compared with control group, The expression level of IL 12 mRNA were decreased and that of IL 13 mRNA were increased in asthmatic children; The sicker the patient was, the lower expression of IL 12 mRNA, the higher expression of IL 13 mRNA; No matter how the IgE level was, there was significantly different between the expression of IL 12 and IL 13 mRNA. Conclusion IL 12 and IL 13 may be one of the factors causing bronchial chronic inflammation.

Objective To evaluate therapeutic effect of endoscopy on duodenal papilla tumor. Methods Clinical data of patients who underwent the endoscopic duodenal papilla tumor resection in Zhongshan Hospital were retrospectively studied from April 2007 to May 2014. Results A total of 21 patients underwent 28 procedures. Postoperative biliary stent were retained in 6 cases (6/28) , with no perforation or postoperative pancreatitis. Delayed bleeding occurred in 7 cases (7/28) and controlled by endoscopic hemostasis, and no death occurred. Mean follow-up was 31. 5 months. There were 6 recurrent cases, and mean recurrence time was 14. 1 months. All these recurrent cases are treated by endoscopy treatments or surgery. Conclusion Endoscopic treatment of duodenal papilla tumor is safe, effective and minimally invasive, but the occurrence of delayed bleeding is worth concern.

Objective To evaluate the feasibility and clinical value of endoscopic decompression with metal stent and colorectal tube for acute malignant colorectal obstruction. Methods With the aid of fluoroscopy, 26 cases with acute malignant colorectal obstruction were treated. Their obstructive sites consisted of rectum(n=14), sigmoid colon(n=8), descending colon(n=2) and transverse colon(n=1). Results In 18 of 26 patients, metal stents were successfully inserted (18/20, 90%), in 6 cases colorectal tube were successfully inserted(6/6, 100%), the total technical success rate was 92. 3% (24/26). Thereafter, 1 patient has no effect, 23 patients showed relief of obstructive symptoms within 1-2 days, the clinical success rate was 88.5% (23/26). Permanent metal stent placements were performed in 13 cases for palliative treatment, 10 underwent subsequent elective surgical resection after 7 ~ 10 days, without complications, such as anastomotic leakage and intraperitoneal infection. One case was failed in recurrent rectal carcinoma after resection, one case with widespread metastatic sigmoid colon carcinoma occurred colon perforation and received immediate Hartmann operation. Recurrent obstruction was detected in one patient with distal stent migration within 6 weeks, and second stent were placed to solve the problems. Stent occlusion from stool impaction was found in one patient 1 month after stent insertion, and was solved by endoscpic interventions. Conclusion Endoscopic decompression with metal stent and colorectal tube can alleviate the acute malignant colorectal obstructive sympotoms with high success rate. It is a simple, safe, effective and well tolerated method, and can obviate colostomy, prominently reduce trauma and agony, and increase the living quality of patients.

Objective To investigate the intervention of chemokine receptor 4(CXCR4) antagonist AMD3100 in lung tissues of rats during pulmonary oxygen intoxication.Methods Forty SD rats were randomly divided into 4 groups:normal pressure air PBS group, normal pressure air antagonist group , oxygen exposure PBS group and oxygen exposure antagonist group, each consisting of 10 animals.The last two groups were compressed to 0.23 MPa at an exponential rate of 0.1 MPa/min by pure oxygen.Pathological changes of lung tissues were observed by hematoxylin eosin stain.Changes in TNF-αand IL-1βexpression levels in the lung tissues of rats were detected by ELISA.Changes in CXCR4 expression levels were ob-served by Western blotting.Results Pathological examination indicated that edema and hemorrhage in the alveolar and pulmonary interstitial tissue of oxygen exposure antagonist group were lighter than in oxygen exposure PBS group.The levels of TNF-α, IL-1βand cleaved-caspase-3 in the lung tissues of the oxygen exposure antagonist group were lower than in oxy-gen exposure PBS group.Conclusion Blocking CXCR4 with AMD3100 can effectively alleviate lung injury during pulmo-nary oxygen intoxication.

Objective To investigate the therapeutic effect and safety of endoscopic submucosal dissection (ESD) for upper gastrointestinal neuroendocrine neoplasms.Methods A total of 19 lesions diagnosed as neuroendocrine neoplasm were treated by ESD.Pathological diagnosis was performed.Adverse eventss were recorded.Patients were followed up for recurrence and metastasis.Results Lesions,0.4-1.5 cm (mean 0.9 cm) in diameter,were all resected at one ESD procedure.The operation time was 15-50 min (mean 20 min).No mass bleeding or perforation occurred.18 cases were histologically diagnosed as neuroendocrine tumors,with 16 as G1 and 2 as G2.One lesion was confirmed as G3 neuroendocrine carcinoma and the patient was referred for extensive surgery.All resected samples were free of residual tumor cell in the lateral and basal margins.Postoperative bleeding occurred in one case and was controlled endoscopically.No recurrence was detected during a mean follow-up of 28 months.Conclusion ESD,as a novel procedure for the treatment of the upper gastrointestinal neuroendocrine neoplasm,is safe and efficacious in clinic.

Objective To evaluate the curative and prophylactic effects of pulmonary surfactant (PS) on neonatal respiratory distress syndrome (NRDS) by two different administration means. Methods 35 neonates with NRDS were divided into groups Ⅰ and Ⅱ randomly, prophylactic group were randomly divided into groups Ⅲ and Ⅳ, the means of administration in all patients was through tracheal tube. Neonates in group Ⅰ and Ⅲ, were given curosurf in several times with different posture, group Ⅱ and IV were given in one time with supine position. Blood gas analysis, index of mechanical ventilation, the duration of mechanical ventilation, hours of oxygen requirement and hospitalization between Ⅰ and Ⅱ group, the incidence of NRDS between Ⅲ, and IV group were analyzed and compared before and after treatment. Results After treatment for 6 and 24 hours, the oxygenation and lung function of group Ⅰ and Ⅱ improved respectively (P<0.05), the total times of assisted ventilation, Supplemental oxygen therapy and hospitalization were significantly decreased, the differences of those index were no significant between Ⅰ and Ⅱ group (P0.05), the incidence of NRDS have no different between Ⅲ and IV group. Conclusion Pulmonary surfactant is effective and safe for treating and prophylacting NRDS, and have no relationship with the means of administration.