Objective To investigate the molecular mechanism of metformin. Methods The changes of protein expression of IRS-1 in liver, skeletal muscle and adipose tissues after treatment with metformin for OLETF rats, a model of spontaneous type 2 diabetes mellitus, were measured by Western blot analysis, and compared with those before treatment. Results 22 weeks after the treatment with metformin, the protein expression of IRS-1 was significantly increased in liver (P0. 05) ;and the protein expression of IRS-1 in adipose tissue was significantly decreased (P

Objective To Investigate the psychological health status of the patients with functional dyspepsia (FD).Methods A total of 80 patients with FD were chosen at random from Ji-Shui-Tan Hospital GI department and 80 normal control were selected from January,2006 to January,2007.MMPI was used as assessment tool.Results Patients with FD have higher scores in hypochondriasis,depression,hysterism,psychasthenia and paranoia than normal control group (P

Objective To Construct the prokaryotic expression vector of the fusion gene IFN-?1b/CSPⅡ. MethodsIFN-?1b was amplified from the human genomic DNA by PCR and cloned into prokaryotic expression vector pGEX-4T-1. The recombinant plasmid pGEX-4T-1/IFN-?1b was constructed. Circumsporozoite proteinⅡ(CSPⅡ) was amplified from the Plasmodium falciparum genomic DNA by PCR and was cloned into the prokaryotic expression vector pGEX-4T-1. The recombinant plasmid pGEX-4T-1/CSPⅡ was constructed. IFN-?1b was cut from the recombinant plasmid pGEX-4T-1/IFN-?1b digested with BamHⅠ and EcoRⅠ and ligated with the recombinant plasmid pGEX-4T-1/CSPⅡ also digested with BamHⅠ and EcoRⅠ . The recombinant prokaryotic plasmid pGEX-4T-1/IFN-?1b/CSPⅡ was constructed. The fusion gene IFN-?1b/CSPⅡ was expressed in E.coli by IPTG. Results The prokaryotic expression vector pGEX-4T-1/IFN-?1b, pGEX-4T-1/CSPⅡ and pGEX-4T-1/IFN-?1b/CSPⅡ were identified by PCR, enzyme digestion and gene sequencing. The expressed fusion protein/IFN-?1b/CSPⅡ in E.coli was identified by SDS-PAGE and Western blot. Conclusion The prokaryotic expression vector of the fusion gene IFN-?1b/CSPⅡ was successfully constructed, which was then expressed in E.coli .

[Objective ] To evaluate the curative effect of urinary retention caused by hyperplasia of prostate gland after treatment of electric acupuncture to Ciliao and Zhongliao acupoints combined with ultrashort wave therapy.[Methods] 35 patients were treated by electric acupuncture to Ciliao and Zhongliao acupoints cooperating with ultrashort wave therapy.Residual urine volumn(RUV),frequency of urinary retention,the therapeutic effect and follow-up were recorded and statistically analyzed.[Results] 29 patients were able to urinate after the therapy,except for 6 patients who were still in urinary retention condition.Effective rate were up to 82.8%.[Conclusion] It proved that the less the frequency was,the better the clinical effect would be.However,no matter how frequent the retention was,our combination therapy still worked,and both effects of the near future and long-term were proved to be fine.Special therapeutic action from Shu acupoint,electric acupuncture's electric current effect,and physical therapy of ultrashort wave contributed to the outcome.

Objective To analyze, the risk factors and related psychological factors in patients with gastroesophageal reflux disease (GERD)and survey the curative effect. Methods All of 200 outpatients with GERD(GERD group) and 200 healthy persons (control group)from January 2006 to January 2008 were randomly selected, and the personal data were investigated. The GERD questionnaire (RDQ) and the Zung-self-rating depression scale (SDS) test were used. Results In GERD group, the proportions of high education, city living, marriage instability ,heavy working pressure, high body mass index (BMI),smoking and drinking habit, peptic disease in family, using nonsteroidal anti-inflammatory drugs (NSAIDs) were higher than those in control group (Pall < 0.01). After treatment, the patients in GERD group had lower scores in the RDQ and SDS test than those before treatment (P< 0.01). Conclusions There are many risk factors in patients with GERD, especially the psychological factors. The therapy of GERD should combine with psy-chotherapy and avoid high BMI, smoking, drinking and overusing the NSAID.

Objective To explore the effect of bone marrow stromal cells (BMSC) transferred by Nell-1 gene combined with biomaterial fibrin glue (FG) to enhance segmental bone defect healing in dog mandible. Methods Nell-1 gene vector was reconstructed in retroviral vector and then transfected BMSC. The protein of Nell-1 gene in transferred cells was determined by immunohistochemistry. Segmental defects were created surgically in the dog’s mandible. The defect was repaired with BMSC transfected by Nell-1 retroviral granules in presence of FG,untransfected BMSC in combination with FG,and FG alone. The control group was left untreated. The defect-repairing capability for each treatment were assessed by gross observation,radiography,and histology at 8th week and 16th week. Results Cells transfected by Nell-1 retroviral granules expressed abundant Nell-1 mRNA and protein in the cytoplasm. Positive results were not found in those cells that were not transferred. The use of BMSC transferred by Nell-1 retroviral granules combined with FG materials exhibited the strongest defect-repairing ability. Gross observation,radiographical and histomorphometric analyses revealed a significantly greater total area of bone formation,increased amount of the new bone in the defects than in those treated with the untransfected BMSC. Conclusion Nell-1 gene transfection may be used to promote the osteogenic ability of BMSC.

Intracerebral delivery of drugs for the treatment of central nervous system disorders is usually limited by the blood-brain barrier (BBB). Transdermal drug delivery systems (TDDS) have the advantage of improving patient compliance and avoiding first-pass effects compared to intravenous, oral and intranasal drug delivery, and are an emerging non-invasive drug delivery route that facilitates long-term drug delivery to patients. The discovery of direct subcutaneous targeting of lymphatic pathways to brain tissue has made TDDS a new brain-targeted drug delivery strategy. At the same time, the development of nano-delivery technology has further facilitated the application of TDDS for targeted drug delivery to the brain. This review summarizes the mechanism of transdermal drug delivery into the brain and the application of TDDS in the treatment of brain diseases, providing new ideas and methods for the treatment of central nervous system diseases.

Objective To evaluate the indications and clinical efficacy of the different surgical methods for lumbosacral tuberculosis.Methods 112 patients suffering from lumbosacral tuberculosis from January 1998 to October 2011 were reviewed retrospectively.Based on American Spinal Injury Association (ASIA) grading system,31 case was classified as grade C,32 as grade D and 49 as grade E.The affected locations were L5,S1 in 66 cases,L4-S1 in 32,and L5-S2in 14 cases.41 cases (posterior group) underwent posterior pedicle screw instrumentation,debridement and allograft; and 38 cases (anterior group) underwent one-stage anterolateral debridement plus allograft and internal fixation.33 (posterior-anterior group) cases experienced posterior pedicle screw instrumentation and anterior debridement and allograft.All cases underwent routine support and anti-tuberculosis treatment before and after operation.The change of erythrocyte sedimentation rate (ESR),signs of tuberculosis activity,graft fusion,neurological recovery and correction of deformity were evaluated in follow-up and compared among three groups.Results The average operating time in posterior,anterior and posterior-anterior group was (150±22) m in,(140± 18) min,(180± 1 8) min respectively.ESR and C-reactive protein (CRP) were recovered to normal 3 months post surgery.The quality of life total score of lumbosacral tuberculosis patients was very low (55.54 ± 9.23).After surgery and drug treatment,the total score and each dimension scores of the SF-36 were significantly improved.Postoperative ASIA classification and 1umbosacral angle were significantly improved.Tuberculosis recurrence occurred in three cases,fixation loosening in two cases,fixation fracture in one case,and all above cases were cured after revision surgery.The others all were cured and bone graft fusion was determined.Conclusion The quality of life of lumbosacral tuberculosis patients were impacted seriously,and which could be significantly improved with surgical intervention.According to the patient MRI,CT characteristics,surgical approach selection was based on lesion location.Effective internal fixation was based on the extent of damage in bone structure and anatomical characteristics.Following above principles,satisfactory clinical results could be achieved.

ObjectiveTo explore the long-term fluctuation of fasting plasma glucose (FPG) and its effect on prognosis in patients surviving for more than 1 year after renal transplantation.MethodsFour hundred and forty-six patients underwent kidney transplantation from January,1993 to December,2008.According to preoperative FPG levels,patients were divided into diabetic,impaired fasting glucose (IFG),and normal fasting glucose (NFG)groups. The changing trend of FPG level was observed and analyzed. For 428 non-diabetic patients before transplantation,the prevalence and different outcomes of post-transplantation diabetes( PTDM ) according to FPG after transplantation were analyzed.The characteristics of the patients with persistent PTDM ( P-PTDM ) and transient PTDM (T-PTDM) were compared.The incidence of complications and patient survival between the PTDM group and non-PTDM groups were also compared.ResultsFPG level was increased early and then decreased in patients after renal transplantation.Of the 428 patients,87 developed into PTDM ( 20.3％ ) including 15 T-PTDM patients ( 17.2％ of total PTDM ),who eventually recovered to NFG or IFG.Compared with P-PTDM group,the incidence of acute rejection episodes was higher for T-PTDM ( P =0.043 ).The incidence of infections,hypertension,and dyslipidemia within the first year,was higher in PTDM group compared with non-PTDM group but patient survival was not different within a mean follow-up of ( 5.65 ± 3.68 ) years.ConclusionPTDM will not be permanent and may recover to NFG or IFG in the course of the disease.Acute rejections are associated with the onset of T-PTDM.The overall patient survival is not affected by PTDM,although complications,such as infections,hypertention,and hyperlipidemia are more frequently encountered in PTDM patients.

Objective To evaluate the status of abnormal glucose metabolism in patients being alive over 3years after liver transplantation and discuss the possible mechanism of post-transplant diabetes mellitus ( PTDM ).Methods In this study, the clinical data of patients with liver transplantation were collected from April 2001 to December 2008. Patients with diabetes mellitus before operation and those who had died and failed to appear during follow-up were exluded. 199 patients living over 3 years after liver transplantation were follow-up. The prevalence of PTDM was evaluated according to fasting plasma glucose(FPG). Among those without diabetes according to FPG,32patients underwent 75 g oral glucose tolerance test (OGTT) , and fasting and 2 h plasma glucose and insulin were determined. 32 patients were divided into three groups [normal, impaired glucose regulation ( IGR ) , and PTDM groups], proportion of PTDM and homeostasis model assessment ( HOMA ) index were calculated. Results In patients alive over 3 years after liver transplantation, the prevalence of PTDM was 34.67% according to FPG. The OGTT result showed that the proportion of PTDM was 9.38%, IGR, including impaired fasting glucose(IFG) and impaired glucose tolerance ( IGT ) , was 56. 25% , while 34. 37% remained normal. The homeostasis model assessment β cell function index( HOMA-β ) decreased progressively from normal group, IGR group to PTDM group,and that in PTDM group was significantly lower than those in normal and IGR group( P＜0.01 ). IGR group had the highest homeostasis model assessment for insulin resistance (HOMA-IR) and PTDM group the next, and HOMA-IR in IGR group was significantly higher than normal group. Conclusion In patients alive over 3 years after liver transplantation, the prevalence of PTDM reached 44.05%. Insulin resistance existed during early period of impaired glucose regulation, while the degeneration of β cell progressed with the worsening of impaired glucose regulation.