Objective To investigate the fasting plasma insulin (FINS) and free fatty acid (FFA) in overweight or obesity patients with type 2 diabetes mellitns (T2DM) Methods 263 patients of T2DM were selected and divided into normal weight group(n = 108) and overweight or obesity group(n = 155) according to body mass index (BMI) , FINS level was detected by chemiluminescence method , and FFA level by colorimetry. 72 subjects without T2DM were taken as controls. Results FINS [(6.18±1.86) mIU/L vs (4.60±2.58) mIU/L, P < 0.01)] and FFA [(0.58±0.25) mmoL/L vs (0.35±0.14) mmoL/L,P < 0.01)] in T2DM group was significandy higher than that of control group. FINS in overweight or obesity group [(7.20±1.99) mIU/L] was higher than that in normal weight group[(5.31±1.21) mIU/L] and control group[(4.60±2.58) mIU/L] (P <0.01). In T2DM group,FiNS was positively correlated with duration(r =0. 334,P <0.01) ,BMI(r =0. 532,P <0. 01) and diastolic pressure (DBP) [r =0. 342 ,P <0.01). Conclusion The FINS level in overweight or obesity patients with T2DM is significantly higher compared to T2DM with normal weight T2DM,and the FFA level in patients of T2DM is significantly higher increased compared to control group,both of which participate in insulin resistence as well as the occurrence and development of T2DM.

Clinical data of 365 patients with type 2 diabetes admitted from December 2010 to May 2011 were retrospectively analyzed,including 130 cases with fatty liver and 235 non-fatty liver cases.There were no differences in gender,age,disease course between two groups (P ＞ 0.05). BMI,glycated hemoglobin (HbAlc),blood pressure,TC,TG,LDL-C,large vessels complications and microvascular complications rate in fatty liver group were significantly higher than those in non-fatty liver group ( all P ＜0.01 ),while there was no difference in rate of peripheral neuropathy (P ＞ 0.05 ).The results indicate that blood glucose,blood pressure,BMI,abnormal blood lipid and chronic complications were closely related to type 2 diabetics with fatty liver.

In this paper,we exhaustively discussed the teaching design of basic life support in processing teaching materials,choosing the methods of teaching and learning,planning the teaching process and reflection after teaching and so on,to introduce how to use the pedagogy and the psychology principles to guide teaching design,for the purpose of improving the teaching quality.

Objective To retrospectively review our experience of treating hepatic biloma in the elderly.Methods Before cyst fenestration,the fistulas between the bile duct and biloma were ligated in the 6 patients.Result All the 6 patients were cured.On follow-up,there was no recurrence.Conclusion The procedure is feasible and safe in the treatment of biloma in the elderly.

ObjectiveTo investigate whether brain microbleeds is associated with antiplatelet-related intracranial hemorrhage (ICH). MethodsForty-three patients with antiplatelet-related ICH treated in our hospital from Jun 2005 to Jun 2010 were investigated in this study.Age, sex and hypertension matched controls with non-antiplatelet-related ICH; and without history of ICH on antiplatelet therapy were selected. ResultsMicrobleeds was more frequent in antiplatelet users with ICH than in matched antiplatelet users without ICH(31/43(72. 1％ ) vs 12/57(21.1％ ), x2 =6. 731, P =0. 011 ) and was more frequent in IHC patients with antiplatelet treatment than those with non-antiplatelet treatment (31/43 (72. 1％ ) vs 17/48 (35.4％), P =0. 030). The frequency of lobar microbleeds(27/43, 62. 8％ ) was significant high in antiplatelet-related ICH than that in non antiplatelet-related ICH (19/48, 39. 6％, x2 =4. 019, P =0. 042). The number of microbleeds was associated with the risk of antiplate-related ICH ( OR =1.38 per additional microbleed, 95％ CI 1.07-1.71, t =0. 806, P =0. 021 ). ConclusionBrain microbleeds are associated with antiplatelet-related ICH.

This research adopts both quantitative and qualitative analytical methods to analyze high-frequency medical words, morphemes and clusters, with the aid of corpora and statistical measures. The result of this research can help teachers arrange their teaching according to the difficulty and frequency of the words, morphemes and clusters.For students, they can put more time and effort on these frequently used words, morphemes and clusters, and thus improve learning efficiency.

Objective To observe the curative effect of esophageal cancer with three-dimensional conformal radiotherapy and acute adverse reaction. Methods 28 cases with esophageal cancer were received three-dimensional conformal radiotherapy from August,2008 to August,2009. The conformal radiotherapy was performed in the way of 200cGy/fraction,5 fractions/week,total dose of 60-64Gy,30-32fraction. In addition,the curative effect and acute adverse reaction were evaluated along the radiotherapy. Results The number of complete relief(CR) cases was 10, part relief(PR) was 15 ,no change was 3 ,and the overall relief(CR + PR) rate was 89.3%. The local control rate and the survival rate in the first year were 75.0% and 60.7%, and second year were 71.4% and 46.4%. The cases of 0 level acute radioactive pneumonia was 14,1 level was 8,2 level was 5,3 level was 1. The cases of 0 level acute radioactive esophagitis was 5, 1 level was 14,2 level was 7,3 level was 2. Conclusion Three-dimensional conformal radiotherapy was a very safe and effective way to treat esophageal cancer. Whether the therapy could improve the long-term survival rate was remained to be observed.

BACKGROUND: Both electroacupuncture and salviae act on prevention and treatment ofis chemia-reperfusion injury, but, whether such action is achieved or not by coordination of both? OBJECTIVE: To probe into the effects of electroacupuncture and salviae on expression of myocardial cellular heat-shock protein 70mRNA that acts on protecting myocardium and on dopamine level that is the mark for myocardial injury after ischemia-repeifusion as well as the interaction between electroacupuncture and salviae. DESIGN: Factorial design of two factors. SETTLNG: Department of Anesthesia of Renji Hospital Affiliated to Shanghai Second Medical Scientific University. PARTICIPANTS: The experiment was performed in Animal Experimental Room of Renji Hospital from September 2001 to December 2002, in which 24 healthy New Zealand white rabbits were employed and randomized into 4 groups, 6 rabbits in each, named ① ischemia-reperfusion group (IR group), ② electroacupuncture group (EA group), ③ salviae group (SA group), ④ electroacupuncture + salviae group (ES group). METHODS: ① IR group: ischemia-reperfusion model was prepared by clipped the anterior descend branch of cardiac coronal artery for 30 minutes and released for 2 hours. ② EA group: modeling was done as the previous method. Twenty minutes before ischemia, electroacupuncture was done on Neiguan (PC 6), Yunmen (LU 2) and Lieque (LU 7), 0.8 V in voltage, 3.0-4.0 Hz in frequency. ③ SA group: modeling was done as the previous method. Before ischemia, salviae was injected intravenously once at 1.5 mg/kg, and was injected before and after reperfusion once respectively at 1.0 mg/kg. ④ ES group: modeling was done as the previous method. Both electroacupuncture and medication were applied in the group. The content of dopamine was determined in blood before ischemia,30 minutes after ischemia and 2 hours after reperfusion successively in rabbits of every group. Reverse transcription-polymerase chain reaction (RT-PCR) was used to determine myocardial heat-shock protein 70mRNA expression in ischemic and non-ischemic areas. RESULTS: After supplemented, 24 rabbits entered result analysis. ① Expression of myocardial heat-shock protein 70mRNA: that after ischemia and reperfusion was increased significantly compared that before ischemia in every group (P ＜ 0.01). That in the rest 3 groups was all higher than IR group,and that in ES group was higher than EA and SA groups (F=4.48, P ＜0.05). CONCLUSION: ① Both electroacupuncture and salivae stimulate expression of heat-shock protein 70 mRNA after ischemia and reperfusion, enhance protein stability of heat-shock protein 70 and alleviate myocardial damage. ② Both electroacupuncture and salivae inhibit increased dopamine content in the body after ischemia and reperfusion, reduce dopamine mediated injury and protect myocardium. ③ Coordination is present between electroacupuncture and salivae.

Objective To observe and investigate the correlation of hemodynamic change of cerebral vessels and functional disturbance in cerebral infarction patient.Methods To investigate hemodynamic characters of cerebral vessels in every type and every group patients via comparing cerebral infarction group(observe group)with control group,comparing stage of recovery with early stage, sever, moderate, mild degree in observe group.Results Apparent hemodynamic change was observed in above 94.10% cerebral infarction patients. The more apparent the hemodynamic change,the severer the functional disturbance.Conclusion The hemodynamic change of cerebral vessels is the predictive index of state of illness and prognosis of cerebral infarction patient.Clinical doctor should pay enough attention to modify it in treatment.

Bradykinin (BK) is a calcium/calmodulin dependent protein kinase Ⅱ (CaMKⅡ) specific activator, and Cyclosporin A (CSA) is reported to suppress protein phosphotase (PP)-2B activity. In vitro studies have shown that CaMKⅡ and PP-2B play an important role in Alzheimer-like phosphorylation of microtube-associated protein tau. To reconstitute an animal model based on the imbalance of protein kinase (s) and protein phosphatase (s) seen in Alzheimer brain, we injected BK and/or CSA into rat hippocampus. The results from behavioral study showed that an obvious disturbance in learning and memory was seen with BK or BK plus CSA injected rats. Moreover, the behavior abnormality appeared earlier in aged rats than young adults of the same kind after the injection. On the other hand, no obvious dysfunction in living and behavior was observed with CSA alone injected rats. The results obtained by immunohistochemical assay indicated that the staining for M4\, 12E8\, PHF-1 and CaMKⅡ was stronger, and for Tau-1 was weaker in BK injected rats compared with Control group. It was also found that the binding of M4 and PHF-1 but not 12E8 to tau was significantly increased in CSA injected rats. As the same as BK injection, binding of Tau-1 to tau was decreased after CSA injection. The immunostaining for 12E8\,PHF-1 and CaMKⅡ was increased, whereas for Tau-1\, M4\, and GSK-3 was decreased after combination injection of BK and CSA. In addition, the staining of PP-2B decreased in all the three models. To our knowledge, this is the first data shown in vivo that the activation of CaMKⅡ induces both Alzheimer-like tau phosphorylation and behavioral disturbance.