OBJECTIVE:To evaluate the status quo and tendency of utilization of hypoglycemic drugs in medical insurance inpatients.METHODS:DDD was used to analyze the data of utilization of hypoglycemic drugs in medical insurance inpatients in class A grade three hospital during 2007～2009.RESULTS:The consumption sum of hypoglycemic drug used for medical patients increased year by year.The rates of increase were up to 14.04% for 2008 and 21.65% for 2009.The consumption sum of insulin increased rapidly.The rate of drug combination was 81.57% among which the rate of using two-drug was 68.66%.CONCLUSION:The new type of hypoglycemic drugs have become the main drugs in the hypoglycemics market.Domestic drug manufacturers should develop effective,safe,economical and be benefit for the treatment of complication so as to decrease medical costs and save the resources of medical insurance.

Not only does autophagy play a vital role in maintaining kidney cell survival and homeostasis,but al-so it is involved in the pathophysiology of several kidney diseases. Recent studies have indicated that autophagy was ac-tivated in kidney cells during acute kidney injury and its regulatory mechanism was unclear. Autophagy activation in kidney may be associated with oxidative stress, endoplasmic reticulum stress, hypoxia inducible factor-1α, p53 and Bcl-2 family. The role of autophagy in acute kidney injury is still controversial. Most believe that it plays a protective role during acute kidney injury. Therefore autophagy will become a novel and potential target for the prevention and treatment of acute kidney injury.

Objective To evaluate the feasibility of measuring phrenic nerve conduction time(PNCT)and elicited compound muscle action potential(CMAP)of diaphragm with surface electrodes.Methods PNCT and amplitude of diaphragm CMAP elicited by unilateral magnetic stimulation(UMS)of the phrenic nerve were measured with surface electrodes and the results were compared with those measured with oesophageal electrodes.Results (1)PNCT measured with oesophageal electrode was similar to those measured with surface electrode;the amplitude of CMAP measured with oesophageal electrode was higher than those with surface electrode.(2)There was a significant relationship between the amplitudes of right CMAP measured with oesophageal electrode and those with surface electrodes,whereas there was no such relationship for the left side.(3)The PNCT and the amplitude of CMAP were not related to age,height,weight and perimeter of abdomen no matter measured with oesophageal or surface electrodes.Conclusion Surface electrodes is a useful and noninvasive method to evaluate the function of phrenic nerve and diaphragm.

As an endogenous organism protective measure in vivo, preconditioning/ postconditioning in the process of ischemia/reperfusion may play common protective mechanisms, such as reducing the generation of oxygen free radicals, activating adenosine receptor, increasing endogenous nitric oxide and heat shock protein, inhibiting immune inflammatory response and neuronal apoptosis, activating intracellular signal transduction pathways, opening mitochondrial ATP-sensitive potassium channels, as veil as closing mitochondrial permeability transition pores. Investigating the common target of these mechanisms may provide a new theoretical basis for developing new drugs and reducing ischemia/reperfusion injury.

Remote organ ischemic preconditioning is to conduct a transient and sublethal ischemic adaptation in non-vital organs before occurring cerebral ischemia/reperfusion injury in remote vital organs. Remote organ iscbemic preconditioning has been studied for as long as 15 years in the field of myocardial iscbemia. However, only recently it has become a therapeutic strategy for the treatment of cerebrovascular diseases, This article briefly reviews the methods and mechanisms involved in the protective effects of cerebral ischemia of remote organ ischemic preconditioning.

Objective To explore change of diaphragm electromyograms in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS) before and after nocturnal sleep, as well as effective nasal continuous positive airway pressure (n-CPAP) ventilation treatment for more than two months. Methods Diaphragm electromyogram was recorded with chest surface electrodes in 22 patients with moderate and severe OSAHS and 24 normal people, and phrenic nerve conduction time (PNCT) and diaphragm compound muscle action potential (CMAP) provoked by unilateral magnetic stimulation (UMS) were measured for them before and after sleep. Measurements were repeated for five patients with severe OSAHS after effective OSAHS patients before and after nocturnal sleep than that in normal people bilaterally, (8.4±0. 6)ms and (8.4±0. 9)ms vs (7. 3±0. 8)ms and (7. 3±0. 8) ms for the left side; and (8.4±1.3) ms and (8. 9 ± 0. 8) ms vs (7.2 ± 0. 8) ms and (7.2 ± 0. 8 ) ms for the right side ( P < 0. 01 ), respectively ; and amplitude of CMAP was significantly lower in OSAHS patients, (0. 60±0. 20)mV and (0. 64±0. 29)mV vs (0. 98 ± 0. 28)mV and (0. 97±0. 27)mV for the left side; and (0. 53±0. 23)mV and (0. 56±0. 26)mV vs (0. 93 ±0. 29) mV and ( 0. 94 ± 0. 29 ) mV for the right side, respectively ( P < 0. 01 ) ; but no significant significantly shortened bilaterally in five patients with severe OSAHS after effective n-CPAP ventilation treatment for more than two months, (8.6±0. 7)ms vs (7.4±0. 5)ms for the lfet side and (7. 8±0. 6)ms vs (6.4 ± 0. 6) ms for the fight side ( P < 0. 05 ), respectively. Conclusions Both phrenic nerve conduction and diaphragm muscle function are weakened in patients with OSAHA, which may be related to hypoxia and/ or disturbance of sleep structure at night.

AIM: To construct HBx eukaryotic expression vector pEYFP-C1-X and eukaryotic expression vector pGL3-P4 driven by P4 promoter of human IGF-II gene and to investigate the effect of HBx on the transcription activity of IGF-II gene P4 promoter. METHODS: HBx gene and P4 promoters were cloned into pEYFP-C1 and pGL3-basic vectors respectively by gene recombination techniques to construct recombinant plasmids pEYFP-C1-X and pGL3-P4. HepG2 cells were transfected with pEYFP-C1-X and the resistant cell clones were selected by G418. Then methylated pGL3-P4 was transiently transfected into the above cell clones, and the transcription activity of P4 promoter was determined by dual-luciferase reporter assay system. RESULTS: (1) Aim fragments HBx gene and P4 promoter that were cloned were 465 bp and 1 246 bp, respectively and the DNA sequences were accordant with GenBank data confirmed by restricted enzyme digestion and sequencing. (2) HepG2-EYFP-X cells that expressed HBx protein were obtained. (3) Luciferase activity of methylated P4 promoter in the HepG2-EYFP-X was more than that of control cell HepG2-EYFP (P<0.01). CONCLUSION: HBx may enhance the transcription activity of the P4 promoter.

AIM: To investigate the effects of early application of thymosin peptide alpha 1 on lymphocyte subsets after operation in patients with hepatocellular carcinoma. METHODS: Forty-six patients with hepatocellular carcinoma were randomly divided into control and treatment groups for this study. Thymosin α1 at dose of 1.6 mg was injected subcutaneously on day 1, 3, and 5 after operation in treatment group. The percentages of CD3+, CD4+ and CD8+ cells, and CD4+/CD8+ ratio in both groups were counted before operation and on day 1, 4, and 7 after hepatectomy. RESULTS: CD4+ cell population and CD4+/CD8+ ratio decreased, but CD8+ increased after operation in control group (P<0 05). In thymosin peptide alpha 1 treatment group, there was no statistical difference in the percentages of CD3+, CD4+, CD8+, and CD4+/CD8+ before and after operation. In addition, thymosin α1 significantly increased CD4+ cell population and CD4+/CD8+ ratio (P<0 05). CONCLUSION: Operation suppresses the immune function in patients with hepatocellular carcinoma. Thymosin α1 increases CD4+ T lymphocyte subsets in patients after operation.

AIM: To study the apoptosis induction of cyclooxygenase - 2 ( COX - 2) inhibitor, celecoxib and adriamycin (ADM) on tumor apoptosis of gastric carcinoma MGC - 803 cells, and to explore their possible molecular mechanism(s) and interactions. METHODS: The number of MGC - 803 cells was observed by MTT assay. Tumor apoptosis was studied by fluorescence microscopy, flow cytometry (FCM), and DNA ladder. RESULTS: MGC -803 cell number was significantly decreased with increasing dose of ADM. Cells were accumulated in G0/G1 phase and the number of cells in S phase was decreased. ADM (5 mg/L) combined with celecoxib (25 μmol/L) markably inhibited the growth of MGC - 803 cells. Significant morphological changes of typical apoptosis were observed after treatment with combined use of celecoxib and ADM. Compared with ADM or celecoxib alone, ADM plus celecoxib obviously enhanced the DNA ladder fragment revealed by agarose gel electrophoresis of DNA. After exposure to combined celecoxib and ADM treatment for 48 h, MGC - 803 cells were accumulated in G0/G1 phase. There was a decrease in the number of cells in S phase as compared to celecoxib or ADM alone. CONCLUSION: Celecoxib and ADM appear to have synergistic effects for the apoptosis induction. This may be an important prospect for applying COX - 2 inhibitors to assist chemical therapy of ADM in clinical use.

Objective:It is demostrated that the porous protein-mineral mechanics model could provide more accurate prediction for biomaterial properties of dentine compared with the other established models.This paper would use the model to reevaluate the mechanical properties and its interacting mechanism of human dentine.Method:By using a porous proteinmineral mechanics model,the effect from the interactions between tubules,pedtubular and intertubular matrix on dentine microstructure was discussed.Results:The dentinal micromechanical properties were dependent on the tubular direction,and the absolute values of the stresses derived from the hydraulic and gas tubular pressures increased parabolically with theincreasing diameter of the tubules.It was also found that the effective elastic constants of the dentine microstructure would vary with the aging and the distribution of mineral and collagen within peritubular and intertubular matrix of detine.Conclusions:The theoretical analyses provided in this paper demonstrated that the microstructural characteristics of tubules,peritubular and intertubular dentinal matdx could have different influences on the micromechanical properties of human dentine,which showed the validity of porous protein-mineral mechanics model,and the limitation of some models that neglected the interacting mechanism.