Objective To evaluate the relationship between serum C‐P levels and microvascular complications in patients with T 2DM. Methods The clinical data of 434 patients with T2DM were retrospectively analyzed. All subjects were divided into three groups based on ΔC‐P (2 hC‐P - FC‐P) tertiles :ΔC‐P1(≤2.2 ng/ml) ,ΔC‐P2(2.3~4.0 ng/ml) and ΔC‐P3(≥4.1 ng/ml). Results The levels of BMI ,TG ,FC‐P were lower ,and the course and HbAl c were higher in ΔC‐P1 group. ΔC‐P level was positively associated with BMI and TG (P< 0.05) ,and negatively associated with prevalence of DR and chronic kidney disease (CKD)in diabetes ,course and HbA1 c.ΔC‐P levels decreased gradually with the progression of DR and CKD. Logistic regression analysis showed that lower ΔC‐P level was the independent risk factor for microvascular complications after adjustment for related risk factors. Conclusion Serum ΔC‐P level is an independent factor for the development of diabetic microvasculr complications in T 2DM.

Objective To study the clinical application s of intravenous myocardial contrast echocardiography (IMCE) in assessing myocardial reperfusion in acute myocardial infarction (AMI) using intravenously infused Levovist. Methods IMCE was performed in 13 AMI patients before and after thrombolytic therapy. The power Doppler signals of the myocardial segments were analyzed and the time-amplitude curves were plotted during Levovist infusion and incremental triggering. The maximal amplitude score (A), the mean ascending slope of the curve(?) and the product of A?? were measured. All patients were followed up for 3 months. And then IMCE indices were estimated for left ventricular function. Results There was a significant increase in A,? and A?? between before and after thrombolysis(P

Objective To establish the feasibility and clinical applications of intravenous myocardial perfusion imaging with Levovist in assessing the coronary microcirculaton reserve.Methods Intravenous myocardial contrast echocardiography (IMCE) was performed pre and post dipyridamole injection in 10 cases with normal coronary angiography (group I) and 8 cases with 50% to 70% stenosis in the lift anterior descending branch(LAD) (group Ⅱ) respectively.A set of special instrumental setting and an integrated imaging approach including power Doppler imaging,incremental triggering imaging and harmonic imaging were utilized to record the apical four chamber view.The power Doppler signals of the septum were analyzed and the time amplitude curves were plotted during Levovist infusion and incremental triggering.The maximal amplitude score (A),the mean ascending slope of the curve(?) and the product of A?? were measured.The reserve of A,? and A?? were also calculated.Results At baseline,both group I and group Ⅱ had normal myocardial perfusion.After dipyridamole infusion,contrast score A increased slightly in group I and decreased in group Ⅱ without statistical significance.Both ? and A?? were increased significantly after dipyradamole (P

Objective To study the clinical application of intravenous myocardial contrast echocardiography(IMCE) in assessing myocardial reperfusion by using intravenously infused Levovist before and after percutaneous coronary interventions(PCI). Methods IMCE was performed in 20 patients with coronary artery disease(CAD) before and after PCI. The power Doppler signals of the myocardial segments were analyzed and the time-amplitude curves were plotted during Levovist infusion and incremental triggering. The maximal amplitude score(A), mean ascending slope of the curve(?) and product of A?? were measured. All the patients were followed up 3 months later for assessing IMCE items of left ventricular function. Results A significant increase was showed in A,? and A?? after PCI(P

OBJECTIVETo observe the therapeutic effect of a drug pair of Radix Astragali and Rehmanniae Radix combined with glucocorticoid (GC) in treating lupus nephritis (LN) patients and its influence on some experimental indices.

METHODSTotally 52 LN patients were randomly assigned to the treatment group (treated by routine Western medicine and a drug pair of Radix Astragali and Rehmanniae Radix, 25 cases) and the control group (treated by Western medicine, mainly by GC and cyclophosphamide, 27 cases). All patients received 6-month therapy. The GC dosage, the withdrawal and reduction dosage of GC, clinical efficacy, systemic lupus erythematosus disease activity index (SLEDAI) score, adverse reactions, and laboratory indicators were recorded.

RESULTS(1) All patients got relieved to some degree with the dosage of GC reduced. The total withdrawal and reduction dosage of GC was slightly higher in the treatment group than in the control group [(50.23 +/- 12.43) mg vs (48.76 +/- 13.61) mg, P > 0.05]. Besides, the prednisone dosage in the treatment group was lower than that in the control group, but without statistical difference (P > 0.05). The ratio of patients in need of adding prednisone for aggravating disease was 24.0%, significantly lower than that in the control group (44.44%, P < 0.05). (2) There was no statistical difference in the SLEDAI score, inflammatory indicators, liver and renal functions, blood electrolytes, blood glucose, blood and urine routines between the two groups (P > 0.05). The 24-h urinary protein count was (1.06 +/- 0.22) g/L in the treatment group, obviously lower than that in the control group (1.43 +/- 0.55 g/L, P < 0.05). (3) There was no statistical difference in the incidence rate of infection, gastrointestinal hemorrhage, psychoneuroses, Cushing's syndrome, cardiovascular anomalies, and femoral head necrosis between the two groups (P > 0.05). But the incidence of adverse reactions such as insomnia, tidal fever, spontaneous sweat, and obesity was less in the treatment group than in the control group (P < 0.05).

CONCLUSIONSUsing a drug pair of Radix Astragali and Rehmanniae Radix combined with GC in treating LN could withdraw the dosage of GC and relieve symptoms it induced. It was advantageous in reducing the dosage of GC and stabilizing patients' conditions.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Lupus Nephritis ; drug therapy ; Treatment Outcome ; Young Adult

To observe the clinical efficacy of nicorandil for treating the patient with cardiac syndrome X (CSX) and its impact on vascular endothelial function. Methods: A total of 140 CSX patients were randomly divided into 2 groups: Control group, the patients received conventional anti-angina therapy and Nicorandil group, based on conventional anti-angina therapy, the patients received additional oral nicorandil treatment. n=70 in each group. All patients received resting emission computed tomography (ECT) and treadmill exercise ECG stress test (TET). Blood levels of endothelin (ET-1), high-sensitivity C-reactive protein (hs-CRP) and nitric oxide (NO) were examined before and 3 months after treatment. Results: Compared with pre-treatment condition, the attack frequency of angina pectoris and positive rate of ECT were decreased after treatment in both groups, P<0.05; in Nicorandil group, the suspicious positive rate and positive rate of TET were reduced after treatment, P<0.05. Compared with Control group, Nicorandil group had the much lower suspicious positive rate and positive rate of TET after treatment, P<0.05. Blood tests indicated that compared with pre-treatment condition, ET-1 and hs-CRP were decreased, NO was increased after treatment in both groups, all P<0.05; blood levels of ET-1, hs-CRP and NO were different between 2 groups after treatment, all P<0.05. Conclusion: Nicorandil could inhibit inflammatory factors, elevate endothelial function and therefore improve micro vascular angina symptoms, increase exercise tolerance obviously.

Objective To explore the characteristics and mechanisms of dysphagia in patients with dorsola-teral medullary syndrome ( DMS). Methods Twelve DMS patients were evaluated clinically and submitted to videofluoroscopic study in order to investigate clinical manifestations and the pathophysiological changes in swallowing. Swallowing function was recorded at discharge and during a three-month follow-up period. Results All patients had difficulties in swallowing and drinking, presenting coughing and throat clearing, and needed nasogastric feeding at admission. Insufficient soft palate elevation was observed in seven patients, who had no other oral phase dysfunction. The pharyngeal phase was injured in all patients. Decreased larynx elevation and invalid swallowing were observed in 10 patients. Delayed pharyngeal swallowing was seen in 8 patients. Under videofluoroscopy, 9 patients showed significantly decreased larynx elevation. Ten patients opened the cricopharyngeal muscles insufficiently, while two could not open at all. Larynx penetration was seen in all patients. Eleven patients were able to return to oral feeding, after 36 days on average (range 13 - 50 d). The patients with a disease history of 3 or more years could not return to oral feeding. Conclusion DMS patients are characterized by decreased larynx elevation and reduced compliance of the cricopharyngeal muscles. Early therapy may provide patients with a good prognosis.

Objective To investigate the effect of combined Metformin and esomeprazole therapy on plasma levels of gastrin,blood glucose,glycosylated hemoglobin(HbA1c) and insulin in elderly patients with type 2 diabetes.Methods A randomized,double-blind,placebo-controlled study of 41 elderly patients with type 2 diabetes was conducted.Patients were randomly assigned into treatment group(combination therapy with Metformin 0.5 g,bid or tid and Esomeprazole 20 mg,qd,for 12 weeks)and placebo group(Metformin monotherapy 0.5 g,bid or tid,for 12 weeks).Fasting blood samples were taken from vein before and after treatment.Fasting serum levels of gastrin,glucose,HbA1c,insulin,lipids,liver and renal functions were compared between the two groups.The homeostasis model of assessment for insulin resistance index(HOMA-IR) and insulin secretion index (HOMA-β)were calculated,and complications were recorded.Results There were no significant differences in body mass index and waist circumference between the two groups.Serum gastrin level was slightly increased in the treatment group 12 weeks after treatment,but without statistically significance [(127.20±9.21)ng/L vs.(131.53±7.84)ng/L,P＞0.05],and serum gastrin level had no significant differences in the placebo group before and after treatment [(128.42±4.58)ng/L vs.(127.51±3.47)ng/L,P＞0.05].However,there were no significant differences in the changes of blood glucose,HbA1c,insulin,HOMA-β and HOMA-IR before versus after therapy,and between the two group(all P＞0.05).Conclusions Combined Metformin and insulin therapy cannot increase serum gastrin and insulin levels and has no significant effect on reducing blood glucose and HbA1c levels in elderly patients with type 2 diabetes.

Objective To explore the regulation mechanism of autophagy-related protein, microtubule-associated protein 1 light chain 3 (LC3), via c-Jun in methotrexate resistant human choriocarcinoma JEG-3 cell lines. Methods Human choriocarcinoma JEG-3 cell lines, and methotrexate resistant choriocarcinoma JEG-3 (JEG-3/MTXR) cell lines were used in our present study. Phosphorylation c-Jun (p-c-Jun) was evaluated after exposure to 0.02 ng/ml methotrexate for 72 hours in both cells by western blot. c-Jun gene was knockdown by small interference RNA (siRNA) in JEG-3/MTXR cells, and LC3 was evaluated by western blot and reverse transcription-PCR. The binding of LC3 promoter with c-Jun protein was detected via chromatin immunoprecipitation assay (ChIP) with or without 0.02 ng/ml methotrexate exposure. Results The results showed that p-c-Jun was up-regulated after methotrexate treatment for 72 hours (1.99±0.20, versus 0.20±0.06 at 0 hour;P<0.05) by western blot analysis in JEG-3/MTXR cell lines. Further investigation demonstrated that c-Jun-siRNA could inhibit the up-regulation of LC3 formation and after methotrexate exposure (LC3 mRNA:1.24±0.17 versus 3.03±0.43;LC3 protein:0.52±0.07 verus 1.20± 0.15; all P<0.05). The binding of LC3 promoter by c-Jun protein was up-regulated after methotrexate treatment by the method of ChIP in methotrexate resistant JEG-3/MTXR cells [(2.95 ± 0.35) times]. Conclusion Autophagy-related gene LC3 expression regulated by c-Jun protein may be involved in the effect mechanism of the development of methotrexate resistance in choriocarcinoma JEG-3 cells.

The localization of human swallowing cortical area remains unclear,which prevents the understanding of pathophysiologic change of peripheral swallowing apparatus and the development of swallowing rehabilitation.Animal experiments have found that the non-human primates, premotor cortex,sensorimotor area,frontal,parietal and temple operculum,orbitofrontal cortex and cingulate cortex are associated with swallowing function.Recently,by using the advanced techniques such as functional MRI,position emission tomography and magnetoencephalography,it was found that a number of encephalic regions participated in the human swallowing,mostly concentrated in primary sensorimotor cortex,premotor cortex,cingule,insular lobe,and parietal-occipital area.However,the exact functions and roles of various encephalic regions and their correlations between various encephalic regions remain unclear.Further studies are needed to identify them.