Arsenic trioxide (As2O3)is the main component of traditional Chinese medicine arsenic,which was initially used in the treatment of blood system diseases.In recent years,studies have found that it also has a good effect on a variety of solid tumors,especially gastric cancer.It has been confirmed that As2O3 can inhibit proliferation and metastasis of gastric cancer cells,induce apoptosis and protective autophagy,inhibite lymphatic formation and angiogenesis,affect the expression of telomere-related proteins in gastric cancer cells.

Macrovascular complications are the main death or disabling causes of diabetic patients.In recent years,the results of a number of clinical trials aimed at preventing diabetic macrovascular complications have been unveiled.Comprehensive and systemic analysis of these results may give great enlightenment to the clinicans,as well as promote the work in preventing diabetic macroangiopathy in China.

Objective To explore the changes of the diurnal rhythm of cortisol secretion and insulin resistance of the type 2 diabetes mellitus(T2DM) patients with depression.Methods The 216 cases outpatient and inpatientof Department of Endocrinology of the Second People's Hospital Changshou, Clinical Psychology of City Mental Health Center of Changshou ,were divided into depression without T2DM group(D group,44 cases), T2DM without depression group(DM group, 124 cases) and the T2DM with depression group(DM-D group,48 cases).And 40 healthy people were from the medical center and as the normal control(NC) group.The levels of fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), Fins, fasting C peptide (FC-P), rhythm in cortisol(Cor) secretion at 3 time points (8:00, 16:00,24:00) and plasma adrenocorticotropin(ACTH) were detected for studies.Results Compared with the D group, DM group and NC group, there were increases of FPG,HbA1c,insulin resistance index (HOMA-IR) in the DM-D group ((11.51 ±2.05) vs.(5.18 ±0.22), (9.47±3.46), (5.11±0.25) mmol/L;(10.28±2.12)％ vs.(5.36±0.34)％, (8.89±2.21)％, (5.53 ±0.32) ％;3.78± 1.08 vs.1.58 ± 0.21,2.70 ± 1.54, 1.14 ± 0.24).Plasma cortisol levels and ACTH levels at time points of 8:00,16:00 in the DM-D group were higher than the group D, DM group and NC group, while insulin sensitivity index(ISI) in the DM-D group was lower than the D group,DM group and NC group (-4.41 ±0.27 vs.-3.57±0.13,-3.92±0.60,-3.22±0.22) ,and the differences were significant (P＜0.05).The loss of normal diurnal rhythm of cortisol secretion were significantly more often inDM-D group than in D group and in DM group(77.1％ vs.50.0％ ,47.6％ ,P＜0.05).The multiple stepwise regression analysis showed that 8:00 Cor and ISI were the related factors for the Hamilton Depression Scale (HAMD) score(95％CI:2.355-3.867, -7.903-2.780,P＜0.001).Logistic regression analysis showed that the level of 8:00 Cor was significant risk factor of the T2DM patients with depression(OR=3.024,95％CI: 1.613-5.668,P=0.002).Conclusion The T2DM patients with depression have higher plasma cortisol level, more abnormal rhythm of cortisol secretion and higher level of insulin resistance.The high level of plasma corfisol maybe significantly related to depression in T2DM patients.

Objective To explore the effect of rhynchophylline and isorhynchophylline on headshakes behavior and levels of monoamine neurotransmitter in model rats with Tourette syndrome.Methods 40 Wistar rats were randomly divided into DOI-induced head-shakes rats (HSR group),haloperidol group,rhynchophylline group and isorhynchophylline group with 10 in each group.The inhibitory effects of rhynchophylline and isorhynchophylline were estimated by observing the HSR behavior.Dopamine (DA) and 5-hydroxytryptamine(5-HT) in the rat striatum were detected by the enzyme-linked immunosorbent assay (ELISA) method.The 5-HT2A receptor mRNA expression in prefrontal lobe cortex of the rats was measured by real-time PCR.Results Compared with HSR group,the head shakes of the rats in haloperidol group and isorhynchophylline group were significantly decreased(P＜0.01),and no change of head-shakes number was observed in rhynchophylline group (P＞0.05).There was no significant difference of head-shakes number between the haloperidol group and isorhynchophylline group(P＞0.05).Compared with HSR group,DA levels in the rat striatum were significantly decreased in isorhynchophylline group and haloperidol group((152.35± 5.80) μ~L vs (111.19±4.30) μg/L,(152.35±5.80) μg/L vs (126.42±3.17) μg/L,P＜0.01),while DA levels in the rat striatum in rhynchophylline group were not changed ((152.35±5.80) μg/L vs (142.71±5.51) μg/L,P＞0.05).There was no significant change of 5-HT2A receptor mRNA expression in rat prefrontal lobe cortex in every group(P＞0.05).Conclusion Isorhynchophylline may have an inhibitory effect on rats with DOI-induced HSR.Isorhynchophylline may decrease the DA levels in the rat stratum with DOI-induced HSR.Rhynchophylline has no significant inhibitory effect on head-shakes behavior and DA levels in the rat stratum with DOI-induced HSR.

Objective To explore the risk factors and targeted therapy for fungus infection in acute exacerbation of chronic obstructive pulmonary disease (COPD) pulmonary.Methods 83 acute exacerbations of COPD patients with pulmonary fungus infection were selected as the observation object(COPD fungal infection group),according to the time sequence of random month by month in acute exacerbations of COPD no secondary fungal infection of the 80 patients hospitalized patients as control group,analysis of risk factors lead to fungal infection.Results Two groups in age,live ICU time,antibiotic use time,hormone use time,albumin level mechanical ventilation people with diabetes mellitus,merger,as cor pulmonale had statistically significant differences (P ＜ 0.05) ; The conditional Logistic multiariate analysis,age,ICU patients live time,antibiotics use time,hormone use time,albumin level was acute exacerbations of COPD factors such as pulmonary fungus infection independent risk factors(P ＜0.01) ;Fungus infection were combined with antimycotic,cured 69 cases (83.13％) improved 12 cases (14.46％),there was no change in 1 case(1.20％),death 1 case (1.20％).Conclusion Patients older age,live long,long time ICU antibiotics and hormones and the low level of albumin is acute exacerbations of COPD pulmonary fungus infection independent risk factors,timely diagnosis and prognosis of patients with antifungal treatment is good.

Objective To investigate the effect of iodine-125 seed implantation in the treatment of unresectable pancreatic carcinoma.Methods A total of 26 pancreatic carcinoma patients were retrospectively analyzed.Patients undergoing palliative operation in combination with iodine-125 seed implantation.jundice recovery,objective tumor response,pain relieved,clinical benefit response,median survival time and complication were investigated.Results Half of cases with jundice has reduced and totally normal in 3 weeks.Abdominal pain was relieved in 94.7％ patients,average recovery duration was (5.0 ± 1.5) d.18 cases had gastroenterol function disorder (69.2％),gastroparesis in six cases (23％) and average recover time was (16 ± 5.1) d.24 of 26 cases were follow up study,median survival time was (12 ± 5.1) months,objective tumor response was smaller than preoperation in 9,no change in 10 and 5 cases became larger than before.Conclusions Palliative operation in combination with iodine-125 seed implantation is safe and effective in the treatment of unresectable pancreatic carcinoma.

BACKGROUND: When the dynamic equilibrium between oxidation system and anti-oxidation system in the body is upset, the overly produced active oxygen-derived free radicals will attack the target organs, thus resulting in the damage to organs and big molecules, and then diseases. Total anti-oxidation capacity (T-AOC), superoxide dismutase (SOD), and nitric oxide synthase (NOS) activity are the majorindexes for the defense system of the body, and their status is closely related to diseases. OBJECTIVE:To explore the level of T-AOC, SOD and NOS in serum,and find out its relationship with lifestyle. DESIGN:Single sample investigation. SETTING:Department of Health Laboratory Technology, College of Public Health of Harbin Medical University. PARTICIPANTS:Totally 531 residents of Bin County aged 20 to 70years were recruited between September 2000 and May2001. MATERIALS:The reagents kits of T-AOC, SOD and NOS were manufactured by Nanjing Jiancheng Bio-engineering Institute. METHODS:The investigators surveyed the residents with the same questionnaire. Questionnaire was made and the investigators were trained in advance. The questionnaire was filled in item by item as required. Questionnaire items consisted of the general situation, financial status, dietary habit, hobby, status of health care, and mental factor. Finally 95 investigation indexes were completed. The activity of serum T-AOC, SOD and NOS of the 531 residents in Bin County was determined, respectively, with reagent kits produced by Nanjing Jiancheng Bio-engineering Institute. The lifestyle factors were analyzed by multivariate stepwise regression analysis,and informed consent was obtained from the participants. MAIN OUTCOME MEASURFS:① Serum T-AOC, SOD and NOS in the participants; ② lifestyle factors affecting T-AOC, SOD and NOS.RFSULTS:According to actual analysis, the 531 participants entered the results analysis. T-AOC was measured in 489 participants, SOD in 525participants, and NOS in 531 participants. ① Indexes of the participants:T-AOC of the males was obviously higher than that of the females [(20.01±7.21), (15.25±6.22) kU/L, P ＜ 0.05]. SOD of the males was slightly lower than that of the females while NOS of the males was slightly higher than that of the females, but there was no significant difference. ②Multivariate stepwise regression analysis showed that risk factors related to T-AOC were gender difference (OR=2.188), educational level (OR=1.859),and the presence of rheumatism, respectively (OR =1.142). SOD-related risk factors were educational level (OR=1.584), years of spirit drinking (OR =1.048), presence of nephritis (OR=1.093), and irradiation (OR=1.770);frequency of tea drinking was a beneficial factor (OR=0.800). NOS-related risk factors were the average amount of cigarette smoking (OR=1.194) and the times of weekly spirit drinking (OR=1.368). However, the beneficial factor that affected serum NOS was the frequency of weekly mutton eating (OR=0.458) CONCLUSION:This experiment revealed that the ability to clean free radical in the 531 subjects was good and that it was better in males than in females. The increased educational level and presence of rheumatism can decrease T-AOC. Drinking, smoking and irradiation decrease SOD activity while the frequency of tea drinking and mutton eating are beneficial factors.

Objective To understand the adherence to current treatment guidelines after training in man-agement of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in emergency department (ED),and to assess the patients' prognosis. Methods Were ED doctors trained with a standard management flow-sheet for AECOPD. The treatment of 152 AECOPD patients recruited from November 1,2008 to April 30,2009 in our hospital and their prognosis were compared to those of 133 AECOPD patients who were treated between Novem-ber 1,0007 to April 30,2008. Results After training, the ED doctors' management of AECOPD is more standard. The rate of the combination of inhaled anticholinergics and short-acting β_2-agonists was increased from 12.0% (16/133) to 27.6% (42/152), the use of inhaled glucocorticosteroids was increased from 52.6% (70/133) to 88.8% (135/152), and the early use of noninvasive imermittent positive pressure ventilation(NIPPV) for the mod-erate to severe was increased from 10.5% (14/133) to 16.4% (25/152). The use of theophylline was decreased from 69.2% (92/133) to 49.3% (75/152). The in-ED mortality rate was decreased from 15.8% (21/133) to 12.5% (19/152). All the difference were significant (P< 0.05). The rate of inhaled β_2-agonists was increased from 78.2% (104/133) to 82.9% (126/152), the use of systemic glucocorticosteroids was decreased from 63.2% (84/133) to 56.6% (86/152),the use of antibiotics was increased from 88.0% (117/133) to 92.8% (141/152), and the use of invasive mechanical ventilation was increased from 14.3% (19/133) to 15.1% (23/152) ,the in-hos-pital mortality rate was decreased from 6.0% (8/133) to 5.3% (8/152), the average days in hospital was decreased from 13.3 to 12.4 days, but the difference was not significant (P > 0.05). Conclusions There are still some differences exist between guideline recommendations and actual ED management of AECOPD. After training ED doctora with a standard flow-sheet, their management of AECOPD is improved. The rate of the combination of inhaled anticholinergics and short-acting β_2-agonists, use of inhaled glucocorticosteroids, and early use of NIPPV is increased. The use of theophylline and the in-ED mortality rate is decreased.

Objective To analyze the viral dynamics and clinical significance during the antiviral treatment by a mathematical model.Methods Six chronic hepatitis B patients were evaluated with a kinetic model(Neumann model)during dose of 0.5 mg/d oral entecavir.Blood samples were drawn for HBV DNA measurement at week 0,2,4,12,24.Non-linear modeling was used to fit individual patient data.Results The median effectiveness in blocking viral production was 99.970%(n=6).The median half-life of viral turn-over was 1.6 d(n=6).The median half-life of infected hepatocytes was 21.3 d(n=5).Compared with the other patients,the c(virions are cleared at a rate)、ε(effectiveness)、δ(infected cell are lost at a rate)value of one patient(eg.6)were all lower and the half-life of virus and infected cells were higher,and eg.6 developed viral break-through after 38 weeks of follow-up.Conclusions Viral load decay showed a biphasic pattern during entecavir therapy which can be described with a mathematical model.The model relates processes of viral infection and replication as well as drug efficacy to model parameters.It indicates the prediction of bio-mathematical model during antiviral treatment.

Objective To investigate the iodine nutritional status in the populations of Guizhou Province after implementation of a new standard of salt iodine and to provide a basis in formulating strategy for control of iodine deficiency disorders.Methods In 2011 and 2014,30 units were sampled in Guizhou Province using the sampling method of Probability Proportional to Size.One primary school was chosen in each unit,by the randomized sampling method,40 or 50 students in each school were sampled for examining their urinary iodine level and for testing their household salt iodine level;12 and 50 children were chosen before and after the adjustment,respectively,for testing their urinary iodine level;near the location of the primary school,1 township was chosen,15-20 pregnant women in each township were sampled to test their urinary iodine level.Results Totally 1215 salt samples were collected before adjustment,the median of salt iodine was 32.2 mg/kg;consumption rate of qualified salt was 96.63％;totally 364 urine samples of 8-10 children were collected,the median of urinary iodine (MUI)of children was 308.9 μg/L;450 urine samples of pregnant women were sampled,and their MUI was 216.5 μg/L,among these,121 below 150 μg/L,the proportion was 26.9％.Totally 1 538 salt samples were collected after the adjustment,the median of salt iodine was 26.6 mg/kg;consumption rate of qualified salt was 96.40％;totally 1538urinary samples of 8-10 children were collected,the MUI of children was 218.3 μg/L;and 601 urinary samples of pregnant women were collected,the MUI was 175.1μg/L,among these,241 below 150 μg/L,the proportion was 40.1％.As can be seen from the results,the percentage of sample below 150 μg/L after the adjustment was increased to 13.2％ compared to that before the adjustment,the difference was statistically significant (x2 =19.89,P ＜0.01).Conclusion After implementation of a new standard of salt iodine in Guizhou Province,the iodine nutrition is suitable in residents,but the iodine nutrition of pregnant women is in a trend of declining,which should be noticed.