Objective To observe autonomic nerve function damage in diabetic patients with gastrointestinal symptoms. Methods Twenty-four patients of diabetes mellitus (DM) with gastrointestinal symptoms, as well as 20 cases of DM without gastrointestinal symptoms and 17 health volunteers were recruited from the clinic of gastroenterology, Jishuitan Hospital, Beijing during December 2008 to May 2009, and standard cardiovascular reflex test was performed for all of them to determine their functions of the autonomic nerve. Results Respiratory rate (an indicator of parasympathetic nerve function) was ( 14 ± 5 ) times per minute in patients of DM without dyspepsia, obviously lower than that in healthy controls [(20±10) times per minute], and that in patients of DM with dyspepsia was (9 ±6) times per minute, obviously lower than that in healthy controls and asymptomatic ones ( P ＜ 0. 05 ). Scores of five indicators of the autonomic nerve functions, and the sympathetic, parasympathetic nerve and overall autonomic nerve functions were significantly higher in patients of DM with gastrointestinal symptoms than those in the patients without dyspepsia and healthy controls. Abnormality rate of autonomic nerve functions was 96 percent (23/24) in the patients with dyspepsia, 58 percent (14/24) in those definitely and seriously involved, and five percent (1/20) in those without dyspepsia. Conclusions Autonomic neuropathy exists in most diabetic patients with dyspepsia, both sympathetic and parasympathetic nerve involved. Impairment of parasympathetic nerve function occurs earlier than that of sympathetic nerve in patients of DM.

Fifty four diabetic patients, including 26 cases with dyspepsia and 28 cases without gastrointestinal symptoms, and 21 healthy volunteers were enrolled in this prospective study.To determine the function of proximal stomach, water load test was performed and the area and circumference of gastric corpus were measured by ultrasonography, and the differences between threshold and maximum were calculated.Results showed that the threshold and maximum drinking volumes in diabetic patients with dyspepsia were lower than those without dyspepsia [(638 ±311) ml vs.(870 ±225) ml and(1 000 ±424) ml vs.(1 360 ±322) ml,t=2.779 and 3.111,P<0.05].The threshold drinking volume in patients without dyspepsia was significantly higher than that of control group [ ( 870 ±225 ) ml vs.( 688 ±225 ) ml, t =-2.450, P<0.05].The differences of drinking volume and corpus area in patients with dyspepsia were lower than those of patients without dyspepsia and controls [(362 ±146) ml vs.(490 ±150) ml, (550 ± 157) ml, t=2.838,3.920,(11.76 ±6.85) cm2 vs.(19.78 ±12.07) cm2, (20.80 ±10.65) cm2,t=2.769, 3.311, P<0.05].The difference of circumference in diabetic patients with dyspepsia was lower than in controls [(3.67 ±2.17) cm vs.(6.22 ±3.06) cm, t=3.139,P<0.05].The study indicates that the proximal stomach function is impaired in diabetic patients, presenting a declined sensory threshold and reduced relax function.

Central exudative chorioretinopathy( CEC),also known as idiopathic choroidal neovascularization (ICN),was more common in middle-aged,appearing the isolated macular choroidal neovascularization lesions ( CNV ).CNV can cause macular hemorrhage,exudativeing and scarring and therefore affect the patient' s central vision.The etiology of CEC is below understanding,and the treatment aimed at CNV.The clinical management of CEC include photodynamic therapy ( PDT),the administration of antibody of vascular epithelial growth factor ( VEGF ),adrenal glucocorticoid drug,combined therapy,transpupillary thermotherapy (TTT),laser photocoagulation,ratiotherapy,surgery,Chinese traditional medicine and gene therapy.The various treating approaches and their mechanisms were reviewed.

Objective: To observe the effect of Tongluo recipe(TLR) on CD4+ CD25+ regulatory T cell in the thymus of experimental diabetic rats. Methods: Totally 112 SD rats were randomly divided into three groups: control group, diabetes mellitus (DM) group, and TLR treatment group. Rat diabetic model was induced by intraperitoneal injection of streptozotocin (60 mg/kg). The TLR treatment group was further divided into two subgroups: prevention group was given intragastric TLR (0.4 g·kg-1·d-1) for 12 weeks starting from the day of streptozotocin injection (TL-1 group), and the treatment group was given intragastric TLR (0.4 g· kg -1·d-1) for 12 weeks starting from 12 weeks after streptozotocin injection (TL-2). The animals were sacrificed at different time points (The control and DM group: 4, 8, 12, 16, 20, and 24 weeks; TLR group: 12 and 24 weeks after administration of TLR). Flow cytometry, H-E staining, and immunochemistry were performed to investigate the change of CD4+ CD25+ regulatory T cell ratio in CD4+ T cells, the thymus morphology, and the expression of Foxp3 protein in the thymus. Results: Compared with the normal control group, diabetic group had a gradually shrunk thymus, a decreased ratio of CD4+ CD25+ regulatory T cells in CD4+ T cells, and a decreased expression of Foxp3. The ratios of CD4+ CD25+ regulatory T cells and the thymus indices in the two TLR groups were significantly higher than those in the diabetic model group(P<0.05). Conclusion: Tongluo recipe can greatly increase the ratio of CD4+ CD25+ regulatory T cells, thymus index, and Foxp3 expression in the thymus, and may protect the thymus CD4+ CD25 + regulatory T cells in experimental diabetic rats.

Objective To assess the courses of evidence-based medicine among graduate students. Methods A sample of 118 graduate students who took the course were surveyed twice by using the same self-designed questionnaire at the beginning and the end of the course.Pre-post comparison was conducted to measure the impact. Results The students were able to grasp the most of the contents of the course,and reshaped their opinions on evidence-based medicine,with which,a positive impact on their medical practice was expected. Conclusion The course of evidence-based medicine for graduate students has resulted in a positive consequence.

Adult ; Cryptococcosis ; physiopathology ; Cryptococcus neoformans ; Duodenal Diseases ; microbiology ; physiopathology ; Humans ; Male

The study aims to establish a quantitative nuclear magnetic resonance (QNMR) method for the determination of the absolute content of bosentan. Proton nuclear magnetic resonance spectroscopy [1H NMR] spectra were obtained in CDCl3 with the internal standard dimethyl terephthalate and zg30 pulse sequence by using a Bruker AVANCE II 400 spectrometer. The content of bosentan is determined with QNMR in comparison with the result obtained by mass balance method. The result is 96.25% by QNMR and 96.54% by mass balance method. A rapid and accurate QNMR method has been established for the quantitative determination of the absolute content of bosentan. The study provides a new way for the quality control and calibration of a new reference standard material, it could be the complementary with the mass balance method for the assay of standard reference.
Calibration ; Magnetic Resonance Spectroscopy ; methods ; Molecular Structure ; Protons ; Quality Control ; Sulfonamides ; chemistry

Angiotensin II ; metabolism ; Cisplatin ; adverse effects ; Humans ; Kidney ; drug effects ; Kidney Diseases ; chemically induced ; metabolism

Adult ; Aged ; Bronchoalveolar Lavage ; methods ; Critical Pathways ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy

Objectives To understand current status of the admission and treatment for the patients with community-acquired pneumonia (CAP) in central hospitals of Shanghai area,and to evaluate the severity of patients admitted to the hospital with CAP by the criteria set in the Guidelines for Diagnosis and Treatment for CAP developed by the Chinese Medical Association in 2006 and provide evidence for its popularization and application throughout the country.Methods Medical records of 137 patients with CAP admitted to the hospital from January 1,2005 to September 30,2006 were retrospectively studied and analyzed with SPSS 10.0 software.Chi-square test and ANOVA were used to evaluate the severity of the patients with CAP by the criteria set in the Guidelines and to correlate it with pneumonia severity index (PSI).Statistical analysis was performed for the difference between length of hospitalization,cost,length of intravenous use of antibiotics,the number of risk factors,and fatality during hospitalization between three groups of patients categorized based on the severity criteria in the Guidelines.Results There existed a good relationship between the criteria for severity of CAP by the Guidelines and PSI,with a Pearson's coefficient of correlation of 0.577,P