To explore the relation between the gene polymorphism of type 2 diabetes patients and their response to sulphonylurea(SU) and accomplish the personal therapy,the range of the SU pharmacogenomics should includes genes involved in the process of SU metabolism and acting,other pathological or physiological process of type 2diabetes also should be investigated,the genes recoding sulphonylurea receptor 1(SUR1),inwardly rectifying K+ channels 6.2(Kir6.2),CYP2C9 and insulin receptor substrate 1(IRS1) are the most important.

Benefits in survival and quality of life have been demonstrated in patients with advanced gastric cancer receiving chemotherapy plus optimal supportive care versus optimal supportive care alone.The taxanes, which are among the most promising cytotoxic agents in clinical use have considerable activity in a number of tumor types.Paclitaxel,especially low-dose weekly administration,has shown encouraging activity in the treatment of advanced gastric cancer as a single agent.Patients treated with the low-dose weekly paclitaxel regimen had a statistically superior response rate and time to disease progression as well as clinically significant prolongation of survival.And it offers a new option for those advanced gastric patients such as the aged,poor performance status(PS) or unsuitable for combination chemotherapy,and those even with no indications for rountine chemotherapy.This review is focused on the clinical reports of low-dose weekly administration of paclitaxel for patients with advanced gastric cancer.

Objective To study current situation of creativity among medical students and its influential factors, and to explore structural equation model about influential factors of creativity. Methods The sample was randomly chosen by using cluster-based sampling method, 413 students in medical university were tested by Williams creativity scale and the influential factors of creativity questionnaire. Results Among the medical student's creativity characters, the most extrusive character was challenge(2.35±0.26), the more important were curiosity(2.29±0.28) and risk-taking(2.21±0.27), and imagination(2.04±0.33) was less important. The structural equation model of influential factors of creativity implied that mental health was the most important factor about improving medical student creativity and by changing study style could promote creativity of medical students. Conclusion By establishing structural equation model, we not only study the influential factors of creativity in realistic view, but also master important extent of each influential factors theoretically.

Objective To investigate the effect of traumatic brain injury on the expressions of glial cell line-derived neurotrophic factor (GDNF) and its receptors in brain stem of rats.Methods 55 male Sprague-Dawley rats were divided into the normal control group, sham surgery group and injury groups. The rats of injury groups were subjected to Marmarou's closed traumatic brain injury and then were subdivided into 1 h, 2 h, 4 h, 8 h, 12 h, 24 h, 48 h, 72 h and 5 d groups according to the time elapsed after injury. The expressions of GDNF and its receptors (GFRα-1 and Ret) were tested with immunohistochemistry.Results Mild expressions of GDNF and its receptors were observed in brain stem of rats in the normal control group and sham surgery group. The number of GDNF positive neurons reached the peak level at 2 h in brain stem after injury, and that of GFRα-1 and Ret positive neurons reached the peak level at 4 h after injury.Conclusion The expressions of GDNF and its receptors increase significantly at the early time in brain stem of rats after injury. The similar temporal patterns of expressions of GDNF and its receptors are observed in brain stem after brain injury.

Objective:To assess the analgesic effects and side effects of buprenorphine sublingual tablet in dental treatment.Methods:500 cases for dental treatment were selected.Before management of teeth,all the patients took 0.2 mg of buprenorphine sublingual tablet.The VAS score,Kuttner face score and side effects after dental treatment were recorded.Results:The VAS scores of the patients underwent preventive,operative and prosthetic treatments were 3.99?2.34,2.72?1.67 and 2.78?1.55,the Kuttner scores of those 1.98?1.23,2.66?1.04 and 2.03?0.93,respectively.Side effect was not observed in all the patients.Conclusion:Buprenorphine sublingual tablet can relieve the pain in dental treatment.

Objective To compare the clinical effects between simple debridement and debridement and interbody fusion and internal fixation for the treatment of children with spinal tuberculosis.Methods 120 cases of children with spinal tuberculosis,were divided into control group(n =60)and observation group(n =60)according to surgical treatment.The control group was administrated with conventional simple debridement treatment,the observation group was administrated with debridement and interbody fusion and internal fixation,the efficacy and quality of life level of two groups of children were compared after treatment.Results The total effective rate of the observation group was 93.3%,which was significantly higher than 73.3% of the control group(χ2 =7.69,P <0.01);The blood loss,operative time,postoperative complication rate of the observation group were (83.47 ±16.35)mL,(35.38 ± 12.34)min and 6.7%,respectively;which in the control group were (165.12 ±22.31)mL,(62.15 ±21.63)min and 21.7% respectively,the difference were statistically significant(t =19.95,20.34,χ2 =8.17,all P <0.05).The adverse reactions(loss of appetite,pain in the spine)rate of the observation group was 8.3%,which was significantly lower than 30.0% of the control group(χ2 =9.02,P <0.05).Conclusion The comparison with conventional simple debridement therapy,the use of debridement over interbody fusion and internal fixation is effective on treatment in children of spinal tuberculosis,children can speed up the recovery with fewer complications,which should be widely applied.

Humans ; Mineral Fibers ; toxicity ; Respiratory Tract Neoplasms ; chemically induced

Objective To evaluate the effection of high mobility group box1protein on septic shock patients with the treatment of glutamine and to demonstrate the mechanism of the treatment of glutamine in patients with septic shock .Methods Seventy-two septic shock cases were selected in ICU of the hospital in May 2009 to July 2012 ,and then two groups were randomly divided ,just named control group and experimental group .After the traditional treatment ,such as fluid resuscitation ,antibiotic therapy and the use of breathing machine ,the control group received low-calorie parenteral nutrition and the experimental group received low-calorie parenteral nutrition combined with intravenous injection of glutamine .APACHEⅡscore ,the concentrations of serum glutamine and HMGB1 were detected at 4 different time points before treatment and the 1st ,3rd ,7th day after the treatment ,to analyze the effec-tion of the change of serum HMBD1 on septic shock patients with the treatment of glutamine .Results The serum glutamine and HMGB1 concentrations were detected with RP-HPLC and ELISA respectively .The result showed that with the intra-group com-parison ,APACHEⅡscores of both two groups after the treatment were lower than that before treatment ,and compare with the control ,the APACHEⅡscore of the experimental group was significantly lower .With disease duration increased ,the concentration of serum glutamine(409 .63 ± 158 .74)μmol/L in the control group was significantly decreased from 3 days after treatment ,that in the experimental group from 1 day (503 .92 ± 167 .66)μmol/L were gradually increased .the HMGB1 concentration in the control group did not appear change ,but that in the experimental group from 1 day (29 .24 ± 23 .91)ng/mL was decreased .Meanwhile ,the level of serum HMGB1[(34 .23 ± 23 .69)ng/mL ,(29 .24 ± 23 .91)ng/mL] concentration decreased synchronized with the changes in concentration of serum glutamine[(470 .05 ± 152 .40)μmol/L ,(503 .92 ± 167 .66)μmol/L] .Conclusion the application of Gluta-mine in treatment of septic shock existed positive significance for patients ,which can effectively increased the concentration of serum glutamine and reduced the concentration of HMGB1 ,to improve the prognosis of patients with septic shock .

Objective To evaluate the effect of early limited fluid resuscitation in treatment of severe pelvic fracture accompanied with traumatic hemorrhagic shock. Methods A retrospective study was done on 96 patients with severe pelvic fractures accompanied with traumatic hemorrhagic shock admitted into hospital from January 2002 to December 2006. Of all, 55 patients ( routine resuscitation group)were dealt with routine fluid resuscitation and 41 (limited resuscitation group) with limited fluid resuscitation. The injury severity, degree of shock, start time of resuscitation, transfusion volume were statistically analyzed and compared in two groups. Results Routine resuscitation group received transfusion volume of (3 432 ± 1 156) ml, with cure rate of 64% and mortality rate of 36% ; while limited resuscitation group received transfusion volume of (2 685 ± 524) ml, with cure rate of 83% and mortality rate of 17%. There was statistical difference between both groups ( P ＜ 0.05 ). Conclusion Limited fluid resuscitation can improve cure rate of severe pelvic fracture accompanied with traumatic hemorrhagic shock.

Objective To evaluate the second generation micro-endoscopic discectomy (MED) system in the treatment of lumbar disc herniation. Methods Eighty-five patients with single or double level lumbar disc herniation were treated with MED under epidural anesthesia from May 2000 to October 2001.Single disc herniation was in 72 cases, double disc herniation in 13 cases; lateral recess stenosis in 15 cases. Results The average following-up period was 14 months and the successful therapeutic results achieved 92 9%(79/85). the patients were allowed to walk 3 d and discharged 3～5 d after operation. The length of incision was only 1.6 cm. Conclusions MED has short-term satisfactory therapeutic efficacy in the treatment of lumbar disc herniation. The suitable indication and precise technique are the key for the operation.