Objective To compare efficacy of different insulin intensive treatment in the treatment of type 2 diabetes,to provide a reference for the programming of intensive treatment of diabetes.Methods 60 type 2 diabetes patients met inclusion criteria were divided into insulin aspart 30 intensive treatment group (I group) and insulin glargine intensive treatment group(Ⅱ group) by random number table,30 cases of each group,I group was given subcutaneous injection of insulin aspart 30,tid,Ⅱ group was given subcutaneous injection of insulin glargine at bedtime,qd.Both groups were treated for 14d,record the time of blood glucose control,observed the occurrence of low blood sugar,detected the HOMA-IR,HOMA-β and clinical efficacy.Results After treatment,the fasting glucose,2h postprandial blood glucose,glycosylated hemoglobin,HOMA-IR,HOMA-β of Ⅰ group and Ⅱ group were (6.0 ± 0.9)mmol/L vs (5.4 ±1.1)mmol/L,(7.4 ± 1.9)mmol/L vs (6.6±2.3)mmol/L,(6.2 ± 1.7)％ vs (6.0 ± 1.9)％,(1.11 ±0.32) vs (1.01 ±0.35),(5.23 ± 1.63) vs (5.46 ±1.41),the fasting glucose,2h postprandial blood glucose,glycosylated hemoglobin,HOMA-IR of Ⅰ and Ⅱ group after treatment compared with those before treatment,the differences were statistically significant.The HOMA-β of Ⅰ and Ⅱ group was significantly higher than that before treatment,the difference was statistically significant.The fasting blood glucose,2h postprandial blood glucose,glycosylated hemoglobin,HOMA-IR,HOMA-β before and after treatment between two groups was not significantly different,the time of blood glucose control between Ⅰ and Ⅱ group were (6.5 ± 2.8) d vs (6.2 ± 2.5) d,the difference was not statistically significant,the low blood sugar of Ⅰ and group Ⅱ was 20％ (6/30) vs 3％ (1/30),there was statistically significant difference.Conclusion The insulin aspart 30 and insulin glargine intensive treatment all can control blood sugar,increase insulin β-cell function,reduce insulin resistance in the treatment of type 2 diabetes,but insulin glargine significantly reduced the incidence of hypoglycemia and insulin glargine is the ideal insulin for blood glucose security control.

Objective To investigate the relationship between plasma visfatin levels and type 2 diabetes mellitus patients with carotid atherosclerosis.Methods 60 subjects were divided into 3 groups,T2DM no carotid atherosclerosis group (20 cases),T2DM with carotid atherosclerosis group (20 cases)and normal control group (20cases).Carotid IMT,plasma visfatin,waist circumference (WC),fasting plasma glucose (FPG),HbA1C,blood lipids,fasting serum insulin (FINS) were assayed or measured in all subjects.Results Plasma visfatin levels in T2DM with carotid atherosclerosis were significantly higher than those in normal control group and T2DM group [ (50.85 ± 20.14) ng/ml vs (18.50 ± 4.60) ng/ml,(50.85 ±20.14) ng/ml vs (35.52 ± 10.18) ng/ml,F = 105.983,P ＜0.01].Correlation analysis showed that plasma levels of visfatin were positively correlated with carotid IMT(r =0.476,P ＜0.01),TG (r =0.328,P ＜0.01),WC (r =0.206,P ＜0.05) and it was negatively correlated with HDL-C(r=-0.298,P ＜0.01).Conclusion Plasma visfatin was correlated with the development of macrovascular complications in T2DM patients,and it might be involved in the atherosclerotic pathological and physiological basis.

OBJECTIVE:To optimize the formulation of dextromethorphan hydrobromide sustained-release tablets. METHODS: The dextromethorphan hydrobromide sustained-release tablets were prepared with HPMC as sustained release matrix. Orthogonal test was performed to optimize the formulation with in vitro accumulative drug release rate as index and the amount of HPMC and lactose as well as ethylcellulose (EC) concentration as factors. Then verification test on the in vitro drug release characteristics of the optimized tablets were performed and the influencing factors (high temperature,high light,and high moisture) were investigated as well. RESULTS: The optimized formulation of dextromethorphan hydrobromide sustained-release tablets was as follows: 30 mg HPMC,50 mg lactose,and 8% EC. The accumulative drug release rate at 8 h was above 70%. In the influencing factor test,the tablets were stable under all conditions except at high moisture condition. CONCLUSION: The optimized formulation of dextromethorphan hydrobromide sustained-release tablets is feasible.

AIM: To determine the effect of exogenous phosphocreatine (PCr) at different concentrations on transient outward potassium (Ito) current in rat ischemic ventricular mid-myocardial (M) cells and to explore the antiarrhythmia mechanism in the treatment of ischemic heart disease. METHODS: M cells were isolated enzymatically from left ventricular mid-myocardium of rats. Peak Ito current was recorded by patch-clamp technique in the whole-cell configuration when M cells were superfused with normal Tyrode solution,simple ischemic solution,and simulated ischemic solution containing PCr at concentrations of 5,10,20 and 30 mmol/L for 10 min. RESULTS: Peak Ito current density of M cells superfused with simple simulated ischemic solution was significantly reduced by (76.1±6.3)% (P<0.05) compared with M cells superfused with Tyrode solution. Ischemic solution containing 5,10,20 and 30 mmol/L PCr reduced peak Ito current density by (57.1±9.6)% (P<0.05),(40.3±10.3)% (P<0.05),(34.3±9.6)% (P<0.05) and (32.1±10.6)% (P<0.05),respectively. There was statistical difference among ischemic solution without PCr and containing PCr at concentrations of 5 and 10 mmol/L groups (P<0.05). No statistical difference among groups of 10,20 and 30 mmol/L PCr was observed (P>0.05). CONCLUSION: PCr reverses the inhibition of Ito current under ischemic condition in M cells,which may be the mechanism responsible for arrhythmia prevention in ischemic heart disease. PCr at concentrations of 0～10 mmol/L exerts significant dose-effect relationship.

Objective To study the method of extracting the gypenoside from crude Herba Gynostemmae Pentaphylli solution.Methods The gypenoside was extracted from crude Herba Gynostemmae Pentaphylli solution by foaming separation.The optimum conditions were obtained through calculating the recovery rate and enrichment ratio.Results Under the optimum conditions:the concentration of the gypenoside in crude Herba Gynostemmae Pentaphylli solution was 3.21 ?g/mL,the gas flow rate was 30 mL/min,the volume of the solution was 110 mL,and pH value was 9.0 as well,the recovery rate of gypenoside was 49.20% and the enrichment ratio could reach 4.511.Conclusion Foam separation is a simple and effective method of extracting gypenoside from crude Herba Gynostemmae Pentaphylli solution.

Objective To investigate the effect of a step-wise diversified teaching mode on cardiac electrophysiology (EP) education. Methods 64 young doctors (male:36, female:28) who studied in EP sub-specialty were enrolled. The atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) were selected as teaching content. All the doctors were randomly divided into traditional teaching group (TT) and step-wise diversified teaching group (DT) according to cross-over design protocol. In TT group, only teaching and answering the questions by teachers were given to students, for the DT group, in different stages of teaching, multiple teach-ing strategy were combined to complete teaching. T test and Chi square test were used to compare the effect of two teaching methods. Results There was no difference of basic features and time of self-studying between the two groups. In examinations, the students in DT group got higher score than TT group[DT:(92.3±9.8) and (93.1±7.8),TT:(88.3±8.6) and (87.1±10.0),P<0.05], and had better perfor-mance of learning interest, initiative, ability of finding and resolving problems, teamwork spirit and so on. Conclusion The step-wise diversified teaching mode contributes improving the quality of instruction of cardiac EP, moreover, arousing learning interest and initiative, enhancing ability of find-ing and resolving problems, teamwork spirit and so on, which is worthy of wide-popularizing in cardiac EP training.

Objective To summarize the experience in surgical treatment of Ebstein anomaly,and evaluate the therapeutic effect.Methods Thirty-five patients of Ebstein anomaly were treated by operation.New York heart association(NYHA)heart function classⅠ?was in 11 cases,classⅡ?was in 14 cases,class III-Ⅳ?was in 10 cases.The cue of echocardiogram about tricuspid valve regurgitation in 24 cases were severe,5 cases were moderate and 6 cases were mild.Two patients accepted tricuspid valve replacement.Thirty-three cases were accepted tricuspid valve repair and right ventricle folded,in which 2 cases accepted Danielson method,and 31 cases accepted Carpentier method,among them,9 cases accepted one and a half ventricular repair.Associated heart anomaly was corrected at the same time.Results One patient died.There were 2 cases with third degree atrioventricular block after tricuspid valve replacement,2 cases with low cardiac output syndrome and 2 cases with atrial fibrillation combined premature ventricular contraction.The heart was lower by chest X-ray and echocardiogram examination,tricuspid valve regurgitation in 22 cases were disappeared,9 cases were mild,3 cases were moderate.All patients were followed up from 1 month to 7years,tricuspid valve regurgitation in 21 cases were disappeared,12 cases were mild,heart function were class Ⅰ-Ⅱ.Because of heart function aggravation,1 patient was operated again 3 years after operation.Condusions Ebstein anomaly is a rare congenital heart disease,Carpentier method tricuspid valve repair can decrease regurgitation obviously and protect right ventricular function.One and a half ventricular repair should be adopted according to the function of tricuspid valve and right ventricle.

Objective To investigate the role of interleukin-17 (IL-17) in spinal dorsal horns in neuropathic pain (NP) in rats and its effect on activation of astrocytes.Methods In vivo experiment Sixty-four male SPF Sprague-Dawley rats,aged 6-8 weeks,weighing 180-200 g,were randomly divided into 3 groups using a random number table:control group (group C,n =16),sham operation group (group S,n =24) and group NP (n =24).The animals were anesthetized with intraperitoneal pentobarbital sodium,the L5,6 spinal nerves of the left side of the rat were gently separated and exposed,tightly ligated with 5-0 silk suture and transected.In group S,the L5,6 spinal nerves of the left side of the rat were only exposed.In group C,no operation was performed.Mechanical pain threshold was measured at day 1 before operation and days 1,3,5,7,10 and 14 after operation.The expression of IL-17,IL-6,IL-1β and tumor necrosis factor-alpha (TNF-α) mRNA in the spinal dorsal horn was determined using quantitative real-time PCR at day 7 and day 14 after operation.At day 7 after operation,the activation of astrocytes in the spinal dorsal horn was detected.In vitro experiment Primarily cultured astrocytes of neonatal rats were randomly divided into 4 groups using a random number table:control group (group C,n=22),10 ng/ml IL-17 group (I10 group,n=18),50 ng/ml IL-17 group (I50 group,n-18) and 100 ng/ml IL-17 group (I100 group,n=22).In I10,I50 and I100 groups,the astrocytes were incubated with the culture medium containing 10,50 and 100 ng/ml IL-17,respectively.The proliferation of astrocytes was detected by MTT at 24,48 and 72 h of incutation or culture.The expression of IL-6,IL-1β and TNF-α mRNA was determined using quantitative real-time PCR.Results In vivo experiment Compared with group C,the mechanical pain threshold was significantly decreased at 3-14 days after operation,the expression of IL-17,IL-6 and IL-1β mRNA in the spinal dorsal horn was up-regualted at 7 days after operation,and the activation of astrocytes was increased in group NP,and no significant change was detected in the mechanical pain threshold at each time point after operation in group S.In vitro experiment Compared with group C,the proliferation of astrocytes was significantly increased at 48 h of incubation in I10 and I50 groups,the proliferation of astrocytes was significantly increased at 48 and 72 h of incubation,and the expression of IL-6 and IL-1β mRNA was up-regulated in I100 group,and no significant change was found in the proliferation of astrocytes in group S.Conclusion Up-regulated expression of IL-17 in spinal dorsal horns may be involved in the maintenance of NP,and the mechanism is related to promoted activation of astrocytes and induced inflammatory responses in rats.

Aim To develop a HPLC method for the determination of the concentration of 1,8-TMP rhein in rat plasma and study the pharmacokinetics of 1,8-TMP rhein in rat plasma after single dose i. v. administration of 1,8-TMP rhein (2, 4, 8 mg·kg - 1 ). Methods Emodin was used as an internal standard. Plasma sam-ples were extracted with methanol and analyzed by HPLC. The mobile phase was methanol - 0. 1% for-mic acid water (78 ∶ 22, V/ V), with a flow rate of 1. 0 mL·min - 1 and UV 275 nm as the detection wave-length. The plasma concentration of 1,8-TMP rhein in rats was determined by HPLC after single-dose intrave-nous injection in rats with 2,4 and 8 mg·kg - 1 of 1,8-TMP rhein, and the pharmacokinetic parameters were caclulated by DAS 2. 1. Results The result of cali-bration curve was linear over the range of 0. 05 ~ 10. 00 mg·L - 1 (r = 0. 996 2). The lower limit of quantifica-tion was 0. 05 mg · L - 1 . The intra-day and inter-day precision (RSD% ) were both lower than 6% , and the extraction recoveries were higher than 88% , respec-tively. The validated method was successfully applied to a pharmacokinetic study after i. v. administration of 1,8-TMP rhein in rats with a dose of 2,4 and 8 mg· kg - 1 . The T1 / 2 was (68. 35 ± 1. 36), (69. 32 ± 2. 1) and (69. 32 ± 2. 03) min, respectively. The AUC0 - t was ( 101. 03 ± 24. 90 ), ( 144. 79 ± 3. 29 ) and (231. 92 ± 19. 30 ) min · mg · L - 1 , respectively. Conclusion A simple and specific HPLC method for the analysis of 1,8-TMP rhein is successfully developed and applied to a pharmacokinetic study in rat plasma.

Objective To detect the expression levels of high mobility group box chromosomal protein 1 (HMGB1) and Th17 cells transcription factors, related cytokines in peripheral blood of rheumatoid arthritis (RA) patients and analyze the relations between HMGB1 and CRP, ESR, RF in RA patients. The other aim of this study is to identify the expression level of HMGBI and the relationship between HMGB1 and Th17 in RA patients. Methods The mRNA levels of HMGB1, RORyt, interleukin (IL)-17 in the peripheral blood mononuclear cells (PBMC) were determined by quantitative real-time PCR (QRT-PCR) from 80 patients with rheumatoid arthritis,including 32 RA patients in stable phase and 48 patients in active phase, and 50 healthy volunteers. The concentration of HMGB1, IL-23, IL-17 in plasma were detected by enzyme linked immunosorbent assay (ELISA), one-way ANOVA and Spearman's correleation were adopted for statistical analysis.Results The mRNAs of HMGBI, RORyt and IL-17 in RA patients were higher than that in healthy control group (P<0.05), especially in active RA patients [ HMGB 1 (0.424±0.262) pg/ml, RORγt (0.34±0.25) pg/ml,IL-17 (1.42±0.38) pg/ml,P<0.01 ] when compared with patients with stable disease. The concentration of HMGB1, IL-23 and IL-17 in the plasma of RA patients was higher than that of the healthy control group (P< 0.05), and was positively correlated with the expression levels of HMGB1, Th 17-associated factors and the level of CRP, ESR, RF in RA patients' plasma(P<0.05). Conclusion The HMGB1 and Thl7 cells levels are higher in active RA patients than those in patients with stable disease, arid there is significant positive correlation between them. Detection of peripheral HMGB1 and Thl7 cell-specific transcription factors or related cytokines can help to understand the development and progress of rheumatoid arthritis and provide clues for new treatment targets for RA.