Effects and mechanisms of electroacupuncture at PC6 on frequency of transient lower esophageal sphincter relaxation in cats

AIM: To investigate the effects of electroacupuncture (EA) at neiguan (PC6) on gastric distention-induced transient lower esophageal sphincter relaxations (TLESRs) and discuss the mechanisms of this treatment. METHODS: ProtocolⅠ: Twelve healthy cats underwent gastric distention for 60 min on the first day. Electrical acupoint stimulation was applied at the neiguan or a sham point on the hip in randomized order before gastric distention, on the third day and fifth day. Those cats that underwent EA at neiguan on the fifth day were named "Neiguan Group" and the cats that underwent EA at a sham acupoint on the fifth day were named "Sham Group" (control group). During the experiment the frequency of TLESRs and lower esophageal sphincter (LES) pressure were observed by a perfused sleeve assembly. Plasma levels of gastrin (GAS) and motilin (MTL) were determined by radioimmunoassay. Nitrite/nitrate concentration in plasma and tissues were measured by Griess reagent. The nuclei in the brain stem were observed by immunohistochemistry method of c-Fos and NADPH-d dyeing. Protocol Ⅱ: Thirty six healthy cats were divided into 6 groups randomly. We gave saline (2 mL iv. control group), phaclofen (5 mg/kg iv. GABA-B antagonist), cholecystokinin octapeptide (CCK-8) (1 μg/kg per hour iv.), L-Arginine (200 mg/kg iv.), naloxone (2.5 μmol/kg iv.) and tacrine (5.6 mg/kg ip. cholinesterase inhibitor) respectively before EA at Neiguan and gastric distention. And the frequencies of TLESRs in experimental groups were compared with the control group.RESULTS: ProtocolⅠ: Not only the frequency of gastric distention-induced TLESR in 60 min but also the rate of common cavity during TLESRs were significantlydecreased by EA at neiguan compared to that of sham acupoint stimulation. C-Fos immunoreactivity and NOS reactivity in the solitarius (NTS) and dorsal motor nucleus of the vagus (DMV) were significantly decreased by EA at neiguan compared to that of the sham group. However, the positive nuclei of C-Fos and NOS in reticular formation of the medulla (RFM) were increased by EA at neiguan. Protocol Ⅱ: The inhibited effect of EA at neiguan on TLESR’s frequency was completely restored by pretreatment with CCK (23.5/h vs 4.5/h, P < 0.05), L-arginine (17.5/h vs 4.5/h, P < 0.05) and naloxone(12/h vs 4.5/h, P < 0.05). On the contrary, phaclofen (6/h vs 4.5/h, P > 0.05) and tacrine (9.5/h vs 4.5/h, P > 0.05) did not influence it. CONCLUSION: Electric acupoint stimulation at Neiguan significantly inhibits the frequency of TLESR and the rate of common cavity during TLESR in cats. This effect appears to act on the brain stem, and may be mediated through nitric oxide (NO), CCK-A receptor and mu-opioid receptors. But the GABAB receptor and acetylcholine may not be involved in it.

Effects of continuous intermedin infusion on blood pressure and hemodynamic function in spontaneously hypertensive rats

Objective To examine the effects of exogenously administered intermedin （IMD,adrenomedullin-2） on arterial blood pressure,cardiac function and the cardiovascular IMD receptor system in spontaneously hypertensive rats （SHRs） as well as to investigate the associated mechanisms.Methods Thirteen week-old male rats were divided in Wistar Kyoto （WKY） group （n =12）,SHR group （n =12）,IMD group （SHRs infused with IMD 1-47 500 ng/kg per hour,n =12）,and ADM group （SHRs infused with adrenomedullin 500 ng/kg per hour,n =12）.Results A two-week continuous administration of low dose IMD 1-47 via mini-osmotic pumps markedly reduced blood pressure,the maximal rates of increase and decrease of left-ventricle pressure development （LV ± dp/dtmax）,left ventricular systolic pressure and heart rate in SHRs.Furthermore,IMD also inhibited protein over-expression of cardiovascular IMD receptors,myocardial Receptor Activity-Modifying Proteins （RAMP1 and RAMP2）,aortic RAMP1,RAMP2,RAMP3,and calcitonin receptor-like receptor （CRLR）;suppressed up-regulation of aortic RAMP1,RAMP2,RAMP3 and CRLR gene expression; and markedly elevated the mRNA abundance of myocardial atrial natriuretic peptide （ANP） and myocardial brain natriuretic peptide （BNP）.Additionally,IMD 1-47 administration in SHRs increased aortic cAMP concentration and reduced myocardial cAMP concentration.Conclusion These findings support the speculation that IMD,as a cardiovascular active peptide,is involved in blood pressure reduction and cardiac function amelioration during hypertension.The mechanism underlying this effect may involve IMD binding of a receptor complex formed by RAMPs and CRLR,and consequential regulation of cAMP levels and other cardiovascular active factors,such as ANP and BNP.

Chinese expert consensus on the non-invasive imaging examination pathways of stable coronary artery disease

1 Introduction Early detection and diagnosis of stable coronary artery disease （SCAD） is essential for proactive secondary prevention of myocardial infarction （MI）, control of disease progress, and reduction of mortality. Clinical decision-making in modem medicine is increasingly dependent on cardiovascular imaging techniques. 2012 ACCF/AHA/ACP/AATS/ PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease has been issued by American Heart Association （AHA）. European Society of Cardiology （ESC） has issued 2013 ESC guidelines on the management of stable coronary artery disease.

Studies on Treatment of Nephrotic Syndrome by Astragalus and Angelica Mixture and Its Mechanism

Objective: To explore the effect, indication and mechanism of the mixture mainly consisted of Astragalus and Angelica (A&A) in treating ne-phrotic syndrome (NS). Methods: (1) Study the effect of A&A on model of chronic NS model induced by puromycin. (2) Study clinically and experimentally the effect of A&A on protein metabolic disorder in NS. (3) Study the effect of A&A on lipid metabolic disorder in NS using quick neph-

Analysis on the reproductive health situation of unmarried floating young women in cities

Objective: To understand the prevalence of RTIs/STIs, the incidence of sex violence and the KAP of the sex and reproductive health among unmarried floating young women.Methods: During Ocb.2002 to Feb.2003, in the maternal and child health hospital of Beijing, Shenzhen, Nanning and Zhengzhou, 1,219 unmarried floating young women who wanted termination of pregnancy and was under 24 years old before induced abortion received gynecological and laboratory examination. At the same time, they also answered a self-questionnaire. Results: The mean age of all respondents was (22.0±1.6) years old. The respondents' average age of having first sexual activity was (20.3±1.8) years old. The rate of induced abortion history was 38.7%. 17.5% of young women had never used contraception. The incidence of sex violence was 15.6%. The prevalence of RTIs and STIs was 56.1% and 9.7%, respectively. Young women were lack of the knowledge about reproductive health care. Conclusions: The reproductive health situation of unmarried floating young women was serious, especially on sex violence and RTIs/STIs and higher rate of induced abortion.

Exploring the mechanisms of Jiangtang decoction in the treatment of diabetic nephropathy based on network pharmacology

Background:The purpose of this research is to predict the mechanisms of the experienced prescription Jiangtang decoction for treating diabetic nephropathy based on network pharmacology,the predicted targets and pathways were validated by celluar experiments.Methods:The active ingredients of the experienced prescription Jiangtang decoction and their putative targets were collected from TCMSP Database and SwissTargetPrediction platform.Diabetic nephropathy-related targets were excavated from GeneCards and DisGeNET database.Then,the interactions of potential targets of the experienced prescription Jiangtang decoction with well-known diabetic nephropathy targets were used to construct the protein-protein interaction network by STRING database and Cytoscape,and screened the core targets via topological analysis.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis were performed by Metascape platform.Finally,we conducted in vitro experiments to verify this prediction of the network pharmacology.A diabetic nephropathy model was established by treating mesangial cells with D-ribose,in which the therapeutic effects of the experienced prescription Jiangtang decoction were evaluated.CCK-8 and LDH assay were used to test cell viability and cell toxicity,cell apoptosis was evaluated by Hoechst 33258 staining,AO/EB staining,levels of ROS were detected by fluorescent probe,the expression levels of MAPK signaling pathway-associated proteins and apoptosis-related proteins Bax were measured by western blotting assay.Results:A total of 74 active ingredients contained and 871 potential identified targets were retrieved from databases.Simultaneously,803 diabetic nephropathy-associated targets were also obtained,180 overlapped targets were considered as potential therapeutic targets of the experienced prescription Jiangtang decoction against diabetic nephropathy.By constructing a protein-protein interaction network and topological analysis,57 core targets were screened.Gene Ontology analysis highlighted 1655 Gene Ontology terms main including apoptotic signaling pathway,regulation of reactive oxygen species metabolic process and positive regulation of cell migration.KEGG enrichment analysis revealed that core targets were enriched mainly in MAPK,AGE-RAGE,TNF,PI3K-Akt signaling pathways.Cellular experiments further demonstrated D-ribose decreased mesangial cells viability,increased LDH release and the ROS level,induced apoptosis and activated the p38/JNK MAPK signal pathways,while the experienced prescription Jiangtang decoction could be useful in attenuation of D-ribose-induced damage.Conclusion:Network pharmacology intuitively shows the multi-component,multi-target and multi-pathway therapeutic effects of the experienced prescription Jiangtang decoction on diabetic nephropathy.By in vitro experiment,it revealed that the experienced prescription Jiangtang decoction has potential therapeutic effects on diabetic nephropathy via alleviating oxidative stress and apoptosis.the experienced prescription Jiangtang decoction treatment significantly inhibited the D-ribose-stimulated JNK and p38 MAPK activation.

Various models of atrial fibrillation induced by acetylcholine and its application in the field of traditional Chinese medicine

Atrial fibrillation is of public health importance and profoundly increases morbidity, mortality and health-related expenditures. Morbidities include the increased risks of cardiovascular outcomes such as heart failure and stroke, and the deleterious effects on quality of life, functional status and cognition. Our purpose is to understand the molecular mechanism of atrial fibrillation, a model under pathological conditions should be established. Acetylcholine, a neurotransmitter in the vagus nerve, has been established with numerous atrial fibrillation models. We will discuss the established model of atrial fibrillation which induced by acetylcholine, aiming to seek a model which are more close to the clinical condition. The underlying mechanisms will be discussed in order to observe the mechanism of antiarrhythmic drugs.

The homology analysis of internal transcribed spacer sequence of ribosomal DNA in common dermatophytes

In order to analyze the sequences of the internal transcribed spacer （ITS） including the 5.8 S ribosomal DNA （rDNA） of common dermatophytes, so as to obtain a rapid and accurate method to identify the species of dermatophytes and to establish the phylogenetic tree of these species to understand their relationship, 16 strains of dermatophytes were collected and preliminarily identified by morphological characteristics. General primers for fungi ITS1 and ITS4 were used to amplify the ITS rDNA of each strains with PCR. The PCR products after purification were sequenced directly and were analyzed through internet. In the results, 11 strains were identified by means of morphological features, among which 5 strains were Trichophyton, 5 strains were Microsporum and 1 was Epidermophytoa, which was consistent with the results by molecular biology. In the 5 unidentifiable strains, 1 strain was proved to be Chrysosporium by molecular biology. These strains studied could be divided into 3 different classes as indicated in the analysis of the phylogenetic tree of the sequences in ITS, which were quite different from those of morphological classification. It is evident from the above observations that the molecular method of analysis on the ITS sequences is a rapid, highly sensitive and accurate approach for the detection of dematophyte species, however, it still exhibits some limitations needing the supplementation with morphological identification.

线粒体DNA A3243G点突变的临床异质性表现

目的探讨线粒体DNAA3243G点突变的临床表现特点。方法以25例临床怀疑为线粒体病,经血或肌肉线粒体DNA检查证实有A3243G点突变的线粒体脑肌病患者为研究对象,分析其临床表现、脑影像学特点、血乳酸水平和肌肉病理检查结果。结果基因检测证实25例患者均存在比例不同的线粒体DNAA3243G点突变,但临床表型有很大不同,其中19例为线粒体脑肌病伴乳酸血症和卒中样发作(MELAS),2例为无法分类的线粒体脑病,2例为松软儿,1例为Kearns-Sayer综合征(KSS),1例为线粒体胃肠肌病。大部分患者脑影像学检查可见病灶,肌肉活检可见蓬毛样红纤维改变,所有患者均有血乳酸水平增高。结论线粒体DNAA3243G点突变的临床表现和脑影像学均呈高度的异质性。对表现为多系统受累的患者,如果同时合并高乳酸血症,就应考虑线粒体病的可能,应进行线粒体DNA突变的检查以明确诊断。

Myocardial infarction secondary prevention study (MISPS)

Background Traditional Chinese medicine (TCM), especially herbal medicine, has been widely used in China and now is also being increasingly used in other countries for the treatment of cardiovascular diseases. Although many studies have demonstrated that certain Chinese herbal products are effective and safe for the treatment of cardiovascular diseases, most of these lack sufficient quality. Therefore, large randomized clinical trials and further scientific research to determine its safety, effectiveness are necessary.QiShen YiQi Dripping Pills (QSYQDP) is a herbal preparation clinically used in the treatment and prevention of coronary artery disease. Preliminary observations have shown its safety and effectiveness. Methods/Design This randomized, controlled trial will recruit 3600 patients with a history of myocardial infarction. Patients will be randomized into two groups by a Centr-Randomized System. One group receives QSYQDP, the other group receive aspirin. This trial protocol will describe eligibility criteria, detailed information on the treatment definition, blinding, endpoints, statistical methods, sample size determination, data management, legal aspects, and the current status of the trial. Discussion This trial is one of the first randomized, controlled clinical trial to evaluate the efficacy and safety of traditional Chinese herbal medicine in the treatment and secondary prevention of coronary artery disease. The results of this study should help to define the role of TCM in modern medical care, as well as to provide the management strategy for CAD patients in China and other countries.

Liver microcirculation after hepatic artery embolization with degradable starch microspheres in vivo

AIM： To observe the dynamic changes of liver microcirculation in vivo after arterial embolization with degradable starch microspheres （DSM）. METHODS： DSM were injected into the proper hepatic artery through a silastic tube inserted retrogradely in gastroduodenal artery （GDA） of SD rats. Fluorescent microscopy was used to evaluate the dynamic changes of blood flow through the terminal portal venules （TPVs）, sinusoids and terminal hepatic venules （THVs）. The movements of DSM debris were also recorded. Six hours after injection of DSM, percentages of THVs with completely stagnant blood flow were recorded. RESULTS： Two phases of blood flow change were recorded. In phase one： after intra-arterial injection of DSM, slow or stagnant blood flow was immediately recorded in TPVs, sinusoids and THVs. This change was reversible, and blood flow resumed completely. In phase two： after phase one, blood flow in TPVs changed again and three patterns of blood flow were recorded. Six hours after DSM injection, 36.9% ± 9.2% of THVs were found with completely stagnant blood flow. CONCLUSION： DSM can stop the microcirculatory blood flow in some areas of liver parenchyma. Liver parenchyma supplied by arteries with larger A-P shunt is considered at a higher risk of total microcirculatory blood stagnation after injection of DSM through hepatic artery.

Risk factors for atypical endometrial hyperplasia in infertile women:possible association with polycystic ovary syndrome

Objective:Endometrial hyperplasia is considered as a precursor of endometrial carcinoma,in which oncogenic potential is low in hyperplasia without atypia,but high in atypical hyperplasia.The objective of this study was to identify the risk factors for atypical endometrial hyperplasia in infertile women.Methods:Fifty four infertile women with endometrial hyperplasia,which were selected from a large cohort of 2 098 women who desired for the future childbearing in our center,were diagnosed by hysteroscopy with directed biopsies or dilation and curettage (D&C),including 44 with hyperplasia without atypia,10 with atypical hyperplasia.Clinical characteristics were recorded in terms of age,body mass index (BMI),parity,insulin resistance,polycystic ovary syndrome (PCOS).Statistical comparison was made between women with hyperplasia without atypia and atypical hyperplasia.Logistic regression analysis was employed to assess the contribution of PCOS,obesity and insulin resistance to atypical hyperplasia.Results:The incidence of endometrial hyperplasia in infertile women was 2.57% (54/2098),which included 10 women (0.48%) were diagnosed as atypical hyperplasia.PCOS in women with atypical hyperplasia (70%,7/10) was significantly higher than those of hyperplasia without atypia (27.27%,12/44).Stepwise regression analysis showed that PCOS contributed maximally to atypical endometrial hyperplasia in infertile women.Conclusion:PCOS is an independent risk factor for atypical endometrial hyperplasia in women with infertility.The infertile women with PCOS are at an increased risk for atypical endometrial hyperplasia and endometrial cancer.

TGF-β may be complimentary to PSA in Chinese prostate cancer

Objective： To investigate the value of the plasma transforming growth factor β1 （TGF-β1） level in diagnosis and prognosis of prostate cancer （PCa）. Methods： The ELISA kits for human TGF-β1 were used to measure the TGF-β1 level in plasmas. A cohort of 295 consecutive PCa patients in recent more than two years in the First Hospital of Peking University of China was enrolled to the study. Furthermore, 55 control subjects were healthy and without evidence of PCa, who were random people that came to the hospital and were identified by prostate biopsy. Results： An age-related frequency chart indicated that 99% confidence interval of the difference with PCa was at the age of 53-85 years. The PCa patients aged 53-85 were classified into three groups according to TNM staging. Group A had Stages TO, T1 and T2. Group B had Stage T3 and Group C had Stage T4. Compared with control group, Group A had the lower level of plasma TGF-β1 （P 〈 0.05）, Group B had the higher level of plasma TGF-β1 （P 〈 0.05） and Group C had the even higher level of plasma TGF-β1 （P 〈 0.01）. According to TNM staging, Group D had Stages TO, T1 and T2 with the normal level of total PSA （tPSA）. Group E with the normal level of tPSA had metastasis after resection. Compared with control group, Group D had the lower plasma level of TGF-β1 （P 〈0.05） and Group E had higher plasma level of TGF-β1 （P 〈 0.01）. Conclusion： The plasma TGF-β1 level decreases at early stage of PCa and increases at later stage of PCa, especially at tumor metastasis after the resection. The plasma TGF-β1 level may therefore be complementary to PSA for PCa prognosis.

Safety and Current Status of the COVID-19 Vaccine among Patients with Breast cancer: A Cross-Sectional Study from China

In this study,we aimed to explore the safety and vaccination coverage data of Chinese patients with breast cancer receiving coronavirus disease 2019(COVID-19)vaccination.The patients were recruited from 41 hospitals across 20 Chinese provinces.The vaccination coverage was approximately 22.4%,and the frequency of total adverse events was 13.3%after the first dose and 9.9%after the second dose.The most frequent adverse reaction within 14 days of the first dose was local pain(5.7%).Unvaccinated patients were very likely to reject the vaccine rather than be hesitant in patients with old age(odds ratio[OR],1.238;95%confidence interval[CI],1.101-1.391),chronic disease history(OR,1.189;95%CI,1.057-1.337),and cancer relapse(OR,1.398;95%CI,1.233-1.585).Of the unvaccinated patients with breast cancer,54.1%opted to receive COVID-19 vaccines if more data were available.Considering the safety but low vaccination coverage for breast cancer,increased positive attitudes and acceptance toward COVID-19 vaccines are important.

Value of sympathetic skin response test in the early diagnosis of diabetic neuropathy

Background Diabetic neuropathy is common in diabetes mellitus. The early stage of diabetic neuropathy is often symptomless and difficult to be treated. The aim of this study was to assess the correlation between the results of the sympathetic skin response (SSR) test and the development of diabetic neuropathy, and explore the use of SSR as an objective basis for the early diagnosis of diabetic neuropathy. Methods The latencies and amplitudes of initiation and of the N and P waves were determined by SSR testing of the extremities of 80 diabetic patients and 30 healthy controls. Results The latencies of initiation and of the N and P waves were significantly (P<0.001) longer in diabetic patients than in the controls, while there was no significant difference in the amplitudes (P>0.05). All but two patients (97.5%) demonstrated abnormal SSR in at least one limb. Conclusions SSR can detect early dysfunction of the small sympathetic fibers in people affected by diabetes mellitus, and may be a useful electrophysiological test for the early diagnosis of diabetic neuropathy.

Polymorphism K469E of intercellular adhesion molecule-1 gene and restenosis after coronary stenting in Chinese patients

Background Inflammation is a major cause of restenosis after coronary stenting. Intercellular adhesion molecule-1 (ICAM-1) is an important adhesion molecule that plays a key role in the tight adhesion between leukocytes and vascular endothelium. The object of this study was to investigate the association between the K469E polymorphism of the ICAM-1 gene and restenosis after coronary stenting in North Chinese population.Methods The ICAM-1 K469E polymorphism was genotyped using polymerase chain reaction-restriction fragment length polymorphism method in 124 patients who had undergone coronary stenting and coronary angiography at least 3 months earlier. Information on clinical risk factors and procedure-related data were also collected.Results Of 124 enrolled patients in total, there were 72 cases of in-stent restenosis. The restenosis rate in this population was 58.1 %. The frequencies of the three possible genotypes of the ICAM-1 K469E polymorphism were: KK genotype 50. 8%, EE genotype 41. 9%, and EK genotype 41. 9%. Among restenosis patients, the frequency of the KK genotype was 58. 3% and the frequency of E allele carriers was 41.7%. Among non-restenosis patients, the frequency of the KK genotype was 40.4%, and the frequency of E allele carriers was 59. 6%. The distribution of these two genotype groups between restenosis and non-restenosis patients was significantly different (P=0. 049). Using multivariate logistic regression, the difference between the two groups was more apparent. The odds ratio of KK homozygotes vs E allele carriers was 2. 6, with 95% confidence interval 1. 2 -5. 8 ( P = 0. 018). After grading of risk factors, we found that the KK genotype was a stronger predictor of in-stent restenosis in obesity or hyperlipemia patients, with an odds ratio of 9. 3 and 3. 7, respectively (P <0. 05).Conclusion In our study population, KK homozygotes of the ICAM-1 codon 469 mutation had a higher risk of restenosis after coronary stenting, especially in the case of obese or hyperlipemia patients.

Human CMTM2/CKLFSF2 enhances the ligand-induced transactivation of the androgen receptor

CKLF (chemokine-like factor)-like MARVEL (MAL and related proteins for vesicle trafficking and mem-brane link domain) transmembrane domain containing (CMTM) is a novel gene family. One member of this family, CMTM2, also named chemokine-like factor superfamily 2 (CKLFSF2), is expressed highly in the testis and moderately in the prostate, marrow and peripheral blood cells. However, the function of human CMTM2 remains unknown. Here, we found that CMTM2 was upregulated in 5α-dihydrotestos- terone (DHT)-treated LNCaP cells. We investigated the relationship between CMTM2 and the androgen receptor. Our results showed that CMTM2 enhanced DHT-mediated androgen receptor (AR) transacti-vation and the expression of prostate specific antigen (PSA). We also observed that CMTM2 enhanced the AR protein level, which was reversed by silencing endogenous CMTM2 expression, which sug-gested that CMTM2 might play an important role in maintaining the AR protein level. We also found that CMTM2 suppressed Akt activation. A previous study showed that Akt could phosphorylate AR at Ser210 and Ser790 and lead to AR ubiquitylation and degradation as well as suppression of AR activity. Taken together, suppressing Akt activation and increasing the AR protein level might be one of the mechanisms for the CMTM2-mediated enhancement of AR transactivation.

Self-monitoring of blood glucose in type 2 diabetic patients in China：current status and influential factors

Background Self-monitoring of blood glucose （SMBG） by individuals with type 2 diabetes （T2D） is crucial for long-term health,yet numerous cultural,economic and health factors can reduce SMBG.Most studies on SMBG adherence have come out of the US and Europe,and their relevance to Asia is unclear.The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.Methods In this multi-center,cross-sectional study,5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics,education level,occupation,income,lifestyle risk factors,duration of diabetes,chronic complications,and frequency of SMBG.Respondents were also asked whether their glycosylated hemoglobin （HbA1c） had been checked in the past 6 months.The most recent values for fasting plasma glucose,2-hour postprandial blood glucose and HbA1c were recovered from medical records.Results Only 1 130 respondents （18.98％） performed SMBG with the recommended frequency,while 4 823 （81.02％） did not.In fact,nearly 2 105 （35.36％） reported never performing SMBG.In the subset of 3 661 individuals on insulin therapy,only 266 （7.27％） performed SMBG at least once a day,while 1 210 （33.05％） never performed it.In contrast,895 of 2 292 individuals （39.05％） on diet/exercise therapy or oral hypoglycemic therapy never performed it.Multivariate Logistic regression identified several factors associated with SMBG adherence：female gender,higher education level,higher income,longer T2D duration and education about SMBG.Conclusions SMBG adherence in our Chinese population with T2D was less frequent than that in developed countries.Several factors influence SMBG adherence：gender,education level,income,T2D duration,therapy regimen and exposure to education about SMBG.

Preliminary Study on the Lesion Location and Prognosis of Cubital Tunnel Syndrome by Motor Nerve Conduction Studies

Background：To study lesions＇ location and prognosis of cubital tunnel syndrome （CubTS） by routine motor nerve conduction studies （MNCSs） and short-segment nerve conduction studies （SSNCSs,inching test）.Methods：Thirty healthy subjects were included and 60 ulnar nerves were studied by inching studies for normal values.Sixty-six patients who diagnosed CubTS clinically were performed bilaterally by routine MNCSs and SSNCSs.Follow-up for 1-year,the information of brief complaints,clinical symptoms,and physical examination were collected.Results：Sixty-six patients were included,88 of nerves was abnormal by MNCS,while 105 was abnormal by the inching studies.Medial epicondyle to 2 cm above medial epicondyle is the most common segment to be detected abnormally （59.09％）,P ＜ 0.01.Twenty-two patients were followed-up,17 patients＇ symptoms were improved.Most of the patients were treated with drugs and modification of bad habits.Conclusions：（1） SSNCSs can detect lesions of compressive neuropathy in CubTS more precisely than the routine motor conduction studies.（2） SSNCSs can diagnose CubTS more sensitively than routine motor conduction studies.（3） In this study,we found that medial epicondyle to 2 cm above the medial epicondyle is the most vulnerable place that the ulnar nerve compressed.（4） The patients had a better prognosis who were abnormal in motor nerve conduction time only,but not amplitude in compressed lesions than those who were abnormal both in velocity and amplitude.Our study suggests that SSNCSs is a practical method in detecting ulnar nerve compressed neuropathy,and sensitive in diagnosing CubTS.The compound muscle action potentials by SSNCSs may predict prognosis of CubTS.

Rejection of insulin therapy among patients with type 2 diabetes in China： reasons and recommendations

Background Insulin injection therapy is one of the most effective treatments for type 2 diabetes meUitus （T2DM）. Many people with T2DM in western countries resist starting insulin therapy; whether the same is true in China is unknown. This survey-based study assessed acceptance and rejection of insulin therapy among individuals with T2DM in China and self- reported reasons for these therapy choices. It also examined what methods may be useful for increasing the rate of insulin acceptance. Methods A multi-center, cross-sectional survey was conducted between April and July 2010 to a convenience sample of inpatients and outpatients at 50 medical centers across 29 administrative divisions in China. Data were collected on sociodemographic and T2DM characteristics, therapy regime, and attitudes toward insulin therapy. Results A total of 6 043 patients were surveyed, and 5 961 complete questionnaires （98.6%） were used in the analysis. Just over half the respondents （3 460, 58.0%） reported negative attitudes to insulin therapy, including 2 508 of the 4 469 patients （56.1%） whose physicians had recommended it to them. Of the patients counseled to use insulin, 800 （17.9%） were unwilling to start therapy and cited the following reasons： inconvenience （64.3%）; concerns over addiction （24.6%）; pain （14.3%）; side effects （14.1%）; and high cost （13.6%）. Logistic regression suggested that respondents would be more willing to undertake insulin therapy if they had received diabetes education, had positive attitudes to the treatment, had higher glycosylated hemoglobin level, or had suffered diabetes for a longer period or with more complications. Conclusions Patients with T2DM in China are often resistant to insulin therapy if they have been diagnosed with the disease for a relatively short time or if the disease has been relatively mild. Educating patients on the benefits of insulin therapy, not only at the initial diagnosis with T2DM but also when insulin therapy becomes necessary, will likely increase their willingness to undertake it.