Showing papers in "National Medical Journal of China in 2009"

Expression of omentin in adipose tissues in obese and type 2 diabetic patients

Abstract: Objeclive To analyze the mRNA expression of omentin mRNA level in subcutaneous and omental adipose tissues of normal,obese,and type 2 diabetic individuals and to investigate the relationship between omentin mRNA expression and serum omentin level,body fat parameters,glucose and Lipid metabolism,and insulin resistance indexes. Methods 36 patients with benign diseases undergoing selective abdominal operation,19 males and 17 females,aged 20 -65,included 12 with normal glucose regulation and normal weight ( NGR-NW group),12 with normal glucose regulation and overweight/obesity (NGR-OW/OB group),and 12 with type 2 diabetes and overweight/obesity (T2DM-OW/OB group). Abdominal subcutaneous and omental adipose tissues were obtained during operation. Real-time quantitative PCR was used to measure the omentin mRNA level . The level of fasting serum omentin was measured by ELISA. Meanwhile blood glucose,HbA1C,hpids and insulin levels were measured. Body weight,BMI and waist hip ratio (WHR) were evaluated and insulin sensitivity was assessed by homeostasis model assessment insulin resistance index (HOMA-IR). Results The omentin mRNA level in omental adipose tissue of the NGR-NW group was ( 1.52 ± 0. 32),significantly higher than that in subcutaneous adipose tissue [ (0.019 ±0.006) ,P <0.01]. The omentin mRNA level of the males was ( 1.46 ± 0.31 ),not statistically different from that of the female [(1.58±0. 29) ,P =0.416]. The omentin mRNA level of the NGR-OW/OB group was (1.18±0.29),significantly lower than that of the NGR-NW group [(1.52±0.32) ,P <0.05],and the omentin mRNA level of the T2DM-OW/OB group was (0.98 ± 0.37 ),both significantly lower than those of the other 2 groups (both P <0.05 ). Partial correlation analysis showed that the omentin mRNA was negatively correlated with HOMA-IR,body weight,WHR,triglyceride,BMI,and fasting insulin,and positively correlated to serum omentin level and HDL-C. Multiple linear regression analysis showed that serum omentin level,HOMA-IR,and body weight were independent variables of omentin. Conclusion Omentin mRNA is highly expressed in omental adipose tissue. The omentin mRNA expression level decreases in the overweight/obese individuals and decreases further when overweight/obesity is combined with type 2 diabetes. Omentin mRNA is positively correlated to serum omentin level,obese indexes,insulin resistance,and lipid metabolism parameters. Decreased omentin gene expression may contribute to the underlying pathophysiology of insulin resistance syndrome. Key words: Diabetes mellitus,type 2; Adipose tissue; Obesity; Omentin

[Treatment of infantile hemangiomas with low-dose propranolol: evaluation of short-term efficacy and safety].

Abstract: Objective To evaluate the short-term efficacy and safety of propranolol in the treatment of infantile hemangiomas. Methods Between October 2008 and May 2009, oral propranolol was applied to 58 infants with heamngiomas at a dose of 1.0 - 1.5 mg per kilogram of body weight per day in Linyi, Shandong and Shanghai. There were 19 males and 39 females 1 to 12 months old with a mean age of 4 months. The primary tumor size was 1.5 cm × 1.0 cm to 18.0 cm × 5.0 cm. Twenty-seven were superficial, nine deep-seated and 22 mixed. The tumors were located in head and neck (n=41), trunk and extremities (n = 12), labium vulvae (n = 2),perianal region (n = 1), perineum (n = 1) and scrotum (n = 1). The patients were hospitalized for 7 to 10 days, continued medication at home and revisited every 2 weeks. The changes of tumor size, texture and color were monitored and recorded at a regular interval. The adverse effects after medication were observed and managed accordingly. The short-term results were evaluated using a 4-point scale system. Results At 24 hours post-medication, all the tumors decreased in density, color and size. The changes became conspicuous within 5 to 7 days. Seven patients had medication for 2 months, 22 for 3 months, 21 for 4 months and 8 for 5 months. The follow-up period was 5 to 9 months. The overall response was scale Ⅰ (poor) in 1 patient (1.7%), scale Ⅱ (moderate) in 12 patients (20.7%), scale Ⅲ (good) in 35 patients (60.4%) and scale Ⅳ (excellent) in 10 patients (17.2%). Statistical analysis showed that the treatment response for deep-seated hemangiomas was significantly better than that for superficial hemangiomas (P 0.05). The main adverse effects were bradycardia (100%), diarrhea (63.8%) and sleep change (30.2%), which resolved after expectant treatment without any significant sequel. No serious adverse effect was observed. Conclusions Oral propranolol treatment at a low dose is a safe and effective regimen for infantile proliferating hemangiomas. And it can be used as the first-line therapeutic modality. The short-term efficacy is excellent while the side effects are minimal. Key words: Hemangioma; Infant; Propranolol

Efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope

Abstract: Objective To explore the efficacy of midodrine hydrochloride in the treatment of vasovagai syncope (VVS) in children. Methods Forty-eight children with unexplained syncope mid prodromata (21 males ,27 females, aged 6 - 17 years, mean 11 years±3 years) were randomly assigned into 3 groups. They were health education group, oresol group mid midodrine hydrochloride group respectively. Oresol group was comprised of children given oresol as first-line therapy in addition to health education and midodrine hydrochloride group patients given midadrine hydrochloride on the basis of oresol group. Repeated head-up tilt testing (HUTT) and follow-ups of at least 6 months were conducted to evaluate the therapeutic efficacy, side effects of midodrine hydrochloride and hemodyuamic changes in treating pediatric VVS. (12/15) respectively. It was significantly higher in cases of midedrine hydrochloride group mid oresol group than that of health education group (P <0.05). However,there was no significant difference in the HUTT- follow-up period, the recurrence rate of syncope was significantly lower in midodrine hydrochloride group than in'other two groups (P <0.05). However, there was no significant difference in the recurrence rate of supine hemodynamic indices (HR, SBP, DBP) between before and after treatment in 3 groups. After midedrine therapy, the effects of midodrine upon changes in systolic and diastolic pressures and heart rate, between upright beginning and supine positions, were statistically significant (P < 0.05). Conclusion Health education and oresol are conventional therapies for pediatric VVS. The efficacy can be enhanced by supplementing midodrine hydrochloride. Such a regimen is effective and safe in treating pediatric VVS. Key words: Syncope,vasovagal; Child; Midodrine; Therapy

Osteoporosis epidemiology update

Abstract: 原发性骨质疏松是遗传和环境因素共同作用的复杂疾病,以骨量减少,骨微结构破坏,骨强度下降,骨骼脆性增加,容易导致骨折为特征的全身性骨骼疾病[1-2].骨质疏松罹患于绝经后妇女和老年男性,我国已经进入老龄社会,骨质疏松的危害凸显严重.本文就骨质疏松及其骨折的流行病学做一简述。

[Plasma levels of nociceptin/orphanin FQ in patients with bipolar disorders and health adults].

Abstract: Objective To investigate the plasma levels of nociceptin/orphanin FQ (OGQ) in patients with bipolar depression and bipolar mania and to analyze the relationship of plasma OFQ to bipolar disorders. Methods Peripheral blood samples were collected from 21 patients with bipolar Ⅱ depression (BD group), 26 patients with bipolar Ⅰ mania (BM group), and 31 health adults (control group). The concentrations of plasma OFQ were measured by radioimmunoassay (RIA). The psychological slams was examined by Hamilton Depression Scale (HAMD), Bech-Rafaelsen Mania Rating Scale (BRMS), and Montgomery and Asberg Depression Rating Scale (MADRS). Results The plasma OFQ level of the BD group was (20 ±4) ng/L, signifgcantly higher than that of the control group [(14 ±5) ng/L, t =5.28 ,P 0.05). In the BD group the plasma OFQ level was significantly positively correlated with HAMD and MADRS scoreds (r=0. 607,P<0.01;r=0.541 ,P<0. 05). In the BM group the plasma OFQ level was significantly negatively correlated with the BRM score (r = - 0. 750, P < 0.01). Conclusion The changes of plasma OFQ level may play a role in the pathogenesis of bipolar disorder and indicate the severity of disease. Plasma OFQ may be a new biological parameter of bipolar disorder. Key words: Bipolar Disorder: Nociceptin

Relationship of serum Chemerin to obesity and type 2 diabetes mellitus

Abstract: Objective To detect the serum Chemerin levels in patients with obesity and newly diagnosed type 2 diabetes mellitus (T2DM) and explore the relationship of serum Chemerin to body fat parameters, glucose and lipid metabohsm, and insulin resistance index (IR). Methods 76 newly diagnosed T2DM patients and 76 subjects with normal glucose regulation (NGR), with the body mass index (BMI) <25 kg/m2 (NW) or ≥25 kg/m2 (OW/OB), 38 in each subgroups each, underwent body measurement including body weight, height, waist circumference, and hip circumference, and waist hip ratio (WHR) and calculation of body mass index (BMI) were calculated. Peripheral blood samples were collected from them to detect the blood lipids, glucose, hemoglobin A1C, fasting insulin (FINS), and fasting C peptide. Homeostasis model assessment insulin resistance index (HOMA-IR) was calculated. ELISA was used to detect the Chemerin level, body mass index (BMI) and waist hip ratio (WHR) were evaluated and insulin sensitivity was assessed by HOMA-IR. Results The serum Chemerin level of the females was ( 109 ± 28) μg/L, significantly higher than that of the males [ (98 ± 23 ) μ/L, P < 0. 05 ]. After adjustment of gender and age, the serum Chemerin level of the OW/OB group, including NGR-OW/ OB and T2DM-OW/OB subgroups, was (113 ± 27) μg/L, significantly higher than that of the NW group [ (94±25) μg/ L, P <0. 01 ], that of the NGR-OW/OB subgroup being the highest. Partial correlation analyses showed that the serum Chemerin was positively correlated with waist circumference, WHR, fasting serum C peptide, HOMA-IR, TG, ALT, γ-GT, and uric acid (r =0.460-0. 182, all P<0.05) and negatively correlated with high density lipoprotein-cholesterol ( r = - 0. 251, P < 0. 01 ). Stepwise regression analysis showed that fasting serum C peptide and TG were the independent variables of Chemerin (β = 0. 328, 0. 280,P < 0. 05 ). Conclusion Serum Chemerin levels are much higher in females and obese subjects are much higher than in men and subjects with normal weight. Serum Chemerin is correlated with insulin level, body fat disposition and lipid metabolism which suggesting that it may play a role in the pathophysiology of obesity and metabolic syndrome. Key words: Obesity; Lipid metabolism disorders ; Diabetes mellitus,type 2

Relationship between polymorphism sites of IRF5, TLR-9 and SLE patients in Shandong Han population

Abstract: Objective To investigate two single nucleotide polymorphism sites of IRF5 and TLR-9 and to detect their relationship with SLE (systemic lupus erythematosus) in a Hart population from Shandong province. Methods The polymorphisms of rs2004640 G/T, rs10954213 G/A in IRF-5 and rs187084C/T,rs352139A/G in TLR-9 were detected with PCR-RFLP in 92 cases of SLE and 88 healthy controls. The genotype and allele frequencies were calculated and analyzed. Results (1) The genotype frequencies of GG, GT and TT in rs2004640 site in SLE were 0.198, 0.521 and 0.281 respectively. The difference was significant between SLE and controls (X~2 = 8.73, P 0.05) ; the genotype frequencies of AA, AG and GG at rs352139 site in SLE were 0.228, 0.533 and 0.239 respectively. There was no difference between SLE and controls (X~2=4.54, P > 0.05). Conclusion The polymorphism of rs2004640 and rs10954213 in IRF5 may be associated with SLE in the population of Han nationality from Shandong province. However, the polymorphism of rs187084 and rs352139 in TLR-9 is not associated with SLE. Key words: SLE; IRF5 ; TLR-9; Single nucleotide polymorphism

[Analysis of drug-induced acute renal failure in Shanghai].

Abstract: Objective To investigate the incidence and prognosis of drug-induced acute renal failure (ARF) in Shanghai. Methods The registration forms of ARF patients admitted in 17 hospitals of and over the middle class in Shanghai from January 1 2004 to December 31 2006 were screened prospectively. The data, such as epidemiology, survival, mortality, and morbidity were analyzed. Results 347 of the 1200 ARF patients (28.9%), 224 males and 123 females, aged (58±20), suffered from drug-induced ARF. 51.0% of the 347 patients were older than 60. 60.2% of the drug-induced ARF in the non-surgical departments were community-acquired, while 55.7% of the drug-induced ARF in the surgical departments were hospital-acquired. Among the non-surgical departments, the incidence of hospital-acquired drug-induced ARF was the lowest in the department of nephrology (9.5%), while higher in the departments of hematology, cardiology, and neurology, and among the surgical departments, it was the lowest in depart6ment of renal surgery, while higher in the departments of liver transplantation, neurosurgery, and cardiovascular surgery. The most common complication was chronic kidney disease (CKD) (n=69, 19.9%), followed by cerebrovascular disease (n=59, 17.0%), diabetes mellitus (n=43, 12.4%), and hypertension (n=41, 11.8%). Renal biopsy showed acute tubular necrosis (18, 37.5%), acute interstitial nephritis (11, 22.9%), and acute infectious tubulo-interstitial nephritis (6, 12.5%). Antibiotics (47.8%) were the head causes of drug-induced ARF, especially aminoglycoside(17.0%) and cephalosporins (12.7%), followed by diuretics (22.2%) and radiocontrasts (13.3%). 22.5% of the drug-induced ARF patients had used two or more drugs. 119 patients (34.3%) needed renal replacement treatment. 100 of the 347 patients (28.8%) died. 188 of the surviving patients (54.2%) had their renal function recovered completely, the renal function of 42 of them (12.1%) was recovered partially, and 17 of then (4.9%) required dialysis when discharged. Conclusion Drug-induced ARF is common with higher incidence in the patients with complications. Antibiotics, diuretic agents, and contrast medium are the main causes. Key words: Kidney failure; Drug toxicity; Incidence

Osteoprotegerin gene polymorphism and therapeutic response to alendronate in postmenopausal women with osteoporosis

Abstract: OBJECTIVE To investigate whether the polymorphism of osteoprotegerin (OPG) gene is associated with the change of BMD (bone mineral density) after alendronate therapy in postmenopausal women with osteoporosis and determine the correlation between genotypes and therapeutic effect. METHODS Eighty postmenopausal osteoporotic patients were recruited with an average age of (64.2 +/- 7.7) years old. Every patient took oral alendronate (Fosamax) 70 mg weekly and Caltrate 600 mg daily for 12 months. At pre- and post-treatment, BMD was measured at lumbar spine 2 - 4 and hip sites. PCR-RFLP was performed for three polymorphisms at the promoter site of OPG gene (A163G, T245G and T950C). RESULTS One-year therapy was accomplished in 67 patients. Patients with G allele (genotype AG and GG) of site A163G, the baseline BMD of vertebral L2-4, inter-troche and total hip were lower than genotype AA [(0.732 +/- 0.113) g/cm(2) vs (0.819 +/- 0.157) g/cm(2), (0.775 +/- 0.101) g/cm(2) vs (0.843 +/- 0.124) g/cm(2) and (0.667 +/- 0.105) g/cm(2) vs (0.725 +/- 0.091) g/cm(2)]. Patients with G allele (genotype TG and GG) of site T245G, baseline BMD of vertebral L2-4, inter-troche and total hip were lower than genotype TT [(0.723 +/- 0.111) g/cm(2) vs (0.819 +/- 0.155) g/cm(2), (0.776 +/- 0.102) g/cm(2) vs (0.840 +/- 0.124) g/cm(2) and (0.670 +/- 0.109) g/cm(2) vs (0.721 +/- 0.091) g/cm(2)]. After one-year therapy, at site A163G, the percentage of BMD change at inter-troche was higher in genotype AA than in genotypes AG and GG [2.50 (3.47)% vs 0.88% (3.47%)%, P = 0.014]. While at site T245G, the percentage of BMD change at inter-troche and total hip were higher in genotype TT than in genotype TG and GG 2.50% (3.47%) vs 0.61% (3.31%), P = 0.011; 2.72% (2.68%) vs 0.89 (3.01%), P = 0.046]. CONCLUSION The G allele of sites A163G and T245G may be the risk allele of postmenopausal osteoporosis. Furthermore, patients with genotypes AA (A163G) and (T245G) show a better therapeutic effect to alendronate.

[Association of CTLA-4 + 49A/G and CT60 gene polymorphism with type 1 diabetes and thyroid autoimmunity].

Abstract: Objective To investigate the association of CTLA-4 + 49A/G and CT60 gene polymorphisms with type 1 diabetes (T1DM) and thyroid autoimmunity.Subjects Three hundred thirty-two T1DM patients and 476 controls were recruited in the study.Method The CTLA-4 + 49 A/G and CT60 polymorphisms of CTLA-4 gene were analyzed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method.Thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) were determined by radioimmunoassay.Glutamic acid decarboxylase antibody (GADA) and proteintyrosine phosphatase antibody (IA-2A) were measured by radioligand immunoassay.Results (1) The CTLA-4 + 49 A/G polymorphism was significantly associated with T1DM complicated with thyroid autoimmunity (OR=2.43,P＜0.01) and with T1DM alone (OR= 1.66,P＜0.05).(2) The CTLA-4 CT60 polymorphism was also significantly associated with T1DM complicated with thyroid autoimmunity (OR=2.67,P ＜0.01) and with T1DM alone (OR = 1.60,P =0.02).(3) T1DM with thyroid autoimmuntiy was characterized by a significantly higher frequency of CTLA-4 CT60 GG genotype (77.8% vs 62.3%,P ＜0.05) and GADA (77.8% vs 57.4%,P ＜0.05) compared to the patients without thyroid antibodies.Conclusion CTLA-4 + 49 A/G and CT60 gene polymorphism coders genetic susceptibility to type 1 diabetes,particularly in patients with thyroid autoimmunity. Key words: Diabetes mellitus,type 1; Thyroiditis,autoimmunity; Cytotoxic T lymphocyte antigen 4

[Clinical study of auricular keloid treatment with both surgical excision and intralesional injection of low-dose 5-fluorouracil and corticosteroids].

Abstract: Objective To investigate whether intralesional injection of low-dose 5-fluomuracil(5-Fu)and corticostemids Can increase the effective rate and decrease the recurrence rate of flurgically excised auricular keloid Methotis Eighty-three patients with 166 total ear keloids were studied,including 79 keloids of helix and 87 of earlobe with an average disease history of 2.9 years.Ear piercing accounted for 92.7%for etiology.Keloids were first surgically rcmoved in order to keep the normal auricular shape.Then intrahsional injeefion of a low-dose of 5-Fu and corticosteroids was given 3-4 weeks after surgery and every 4 weeks afterwards.If no recurrence,the injection was given every 2 to 3 months with gradually tapered dose.The evaluation smndard includes:patients with no recurrence 6 months after stopping drug injection and maintaining of the noFmal auricular shape are considered as"cure":those remain having minor auricular deformity 6 months post.operation with no recurrence and needing further treatment are considered as "effective".Results The therapeutic period for 83 patients Was 2-26 months(meas:7 months).The patient follow-ups were 0-49 months(mean:9 monks)after withdrawing drug injection.There were 39 cured cases(47.0%)and 44 effective cases(53%).The total effective rate was 100%.Normal auricular shapes were achieved in 77 cases(92.7%).Conclusion Surgical removal of auricular keloid followed by intralesional injection of low-dose 5-Fu and corticostemid8 is an effective method to treat auricular keloid and prevent its relapse. Key words: Ear diseases; Keloid; Fhomuracil; Glucecorticoids

Decellularization technology application in whole liver reconstruct biological scaffold

Abstract: Objective To explore Sift innovative method for preparing a whole-liver reconstruct scaffold with intact three-dimensional geometry, vasculature and bile duct by decellularization technology.Methods The portal vein was annulated and perfused sequenfially with 1% Triton X-100 and 1% SDS for about 4 h,and then was perfused with phosphate buffered saline to dilute SDS residue.The retained stmcRlre was evaluated by histological analyses,including macroscopic,Hematoxylin-Eosin staining,Masson's trichrorne staining,orcein staining and SEM.The liquid polymer preparation 8%-10%,which was made of chlorinated poly vinyl chlofide(CPVC as solute),acetone(as solvent)and pigment,was injected into portal vein and bile duct to demonstrate tIle integrity of the portal vein and bile duct. The scaffold was cut into slices with the thickness of about 50μm and co-cultured with C3A cell line.Results Macroscopic examination showed that the deedlularized liver WS8 transparent and intrahepatic Gli8son's system could be observed.H&E staining of slices of decellularized liver demonstrated no intact cells or nuclei existect Masson trichrome staining revealed collagen retained.Orcein staining showed that there were elastic fibers.SEM showed the network of ECM Was intacL C3A-to-scaffold co-culture revealed the scaffold of a good biocompatibility.Conclusion Peffusion with detergents throuSh portal vein for liver decellularization is an efllcient method to obtain a completely whole-1iver scaffold for hepatic organ reconstruction. Key words: Liver; Biological scaffold; Decellularization

[Ischemic postconditioning protects hypertrophic myocardium by ERK1/2 signaling pathway: experiment with mice].

Abstract: Objective To investigate the effects of ischemic postconditioning (IPest) in protecting hypertrophic myocardium subjected to ischemic-reperfusion (I/R) and to study the role of extracellular regulated protein kinase (ERK1/2) in mediating such protection. Methods Transverse aortic constriction (TAG) operation was performed on 12-week-old C57/BL mice to establish left ventricular hypertrophy models. Sixty-four isolated TAG mouse hearts were mounted onto the Langendorff perfusinn system and randomly divided into 4 equal group: (1) I/R group undergoing stable perfusion for 30 rain, ischemia for 30 min, and re-perfusion for 120 min (an I/R cycle) to cause hypertrophic myocardium I/R injury, (2) IPost group undergoing ischemia for 10s and reperfusion for 10s, totally 3 cycles (60s) before reperfusion for 120 rain, (3) I/R + PD98059 (an ERK1/2 inhibitor) group undergoing perfusion of Krebs-Henseleit(KH) buffer with PD98059 10-5>mol/L for 15 min and perfusion of KH buffer without PD98059 at the beginning of re-perfusion, and (4) IPost + PD98059 group undergoing 3 cycles of IPost and perfusion of KH buffer with PD98059 10-5mol/L for 15 min at the beginning of re-perfusion. Hemodynamic examination was conducted 120 min after re-perfusion to measure the left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), maximal uprising velocity of left ventricle pressure (dp/dtmax), and minimal uprising velocity of left ventricle pressure (dp/dtmin). After the I/R procedure the mvocardium of the left ventricle was isolated to detect the infarction size (IS). Weetem blotting was used to detect the protein expresson of extracellular signal-regulated kinase (ERK) 1/2, phospharylated ERK1/2, Bcl-2, Bax, and mitochondrial and cytosolic eytochrome (Cyt). C. TUNEL was used to detect the apoptotic rate. Results The LVSP and dp/dtmaxlevels of the IPost group were(85 ±4)mm Hg and (3811±230) mm Hg/s, both significantly higher than those of the I/R group [(68 ±5)mm Hg and (2830±230) mm Hg/s respectively, both P < 0.05] .Compared with the I/R group, the protein levels of phosphorylated ERK1/2, Bcl-2, mitochondrial CytC of the IPost group were all significantly higher , the protein levels of Bax and cytosolic CytC, and apoptosis index were significantly lower (all p < 0. 05), and the IS was smaller (P < 0. 05). I/R + PD98059 showed no effects on the above-mentioned parameters. However, the results of the IPost + PD98059 group showed that in the first 15 min of reperfusion addition of PLY)8059 reversed all changes observed in the IPost group and eliminated the IPost protection by increasing IS to a level similar to that in the I/R group. Conclusion IPost has protective effect in hypertrophic myocardium with L/R injury in vitro. ERK1/2 signaling pathway is involved in the protection of IPost by regulating the myocyte apoptosis. Key words: Ischemic Preconditioning; Myocardium ischemic; Reperfusion injure; Mitogen-activated protein kinase

[Meta-analysis of unicompartmental knee arthroplasty versus high tibial osteotomy in the treatment of unicompartmental knee osteoarthritis]

Abstract: Objiective To assess the efficacy of UKA versus HTO in the treatment of unicompartmental knee osteoarthritis.Methods Comparative studies of UKA and HTO were retrieved from the domestic and foreign literatures and included for a meta-analysis.Resuits Seven eligible randomized controlled trials included 196 UKAs and 219 HTOs.The result of Meta-analysis indicated that the ratio for an excellent outcome was higher in UKA than HTO.The combined OR was 2.43,95%CI(1.46,4.05)(P=0.0006).The risks of revision and complications were lower in UKA than HTO.The combined OR was 0.47 and 0.24 and 95%CI(0.23,0.97),(0.10,0.56).Conclusion UKA reduces the risk of postoperative revision and complications and provides excellent outcomes. Key words: Anhroplasty; replacement; Osteotomy; Meta analysis

[Protective effects of L-carnitine upon testicular ischemia-reperfusion damage in rats].

Abstract: Objective To investigate the protective effects of L-carnitine upon testicular ischemiareperfusion injury in rats. Methods Sprague-Dawley rats were divided into 3 groups (n = 10). In those animals undergoing unilateral testicular torsion, right testes were rotated 720° for 2 h. Sham operated group served as a control group. Torsion group underwent 2 h torsion and saline was injected intraperitoneally at 30min pre-detorsion. Treatment group underwent similar torsion but L-carnitine (500 mg/kg) was infused intraoperatively. The right testes of 5 animals in each group were excised after 4 h reperfusion for measuring the levels of malondialdehyde (MDA) and heat shock protein 70 (HSPT0), evaluation of activities of antioxidant enzyme including superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). Histopathoiogical changes and germ cell apoptosis indices (AI) were determined at 24 h postdetorsion in right testes of the remaining 5 animals in each group. Results The mean number of apoptotic nuclei per tubule cross section and the malondialdchyde level were significantly lower in treatment group as compared with torsion group[AI (6.87 ± 2.47) vs (17.13 ± 3.56), MDA (160 ± 15) vs (199 ± 15) nmol/g].Activities of antioxidant enzyme and the level of HSP70 were significantly higher in treatment group than those in torsion group[SOD(1638 ± 153) vs (1 078 ± 158) U/g, CAT(317 ± 28) vs (188 ± 33) U/g, GPx (667±94) vs (311±65) U/g,HSP70(0. 87 s0. 13) vs (0.25 ±0.04)]. The pathological damage of testes in the treatment group was lighter than that in the torsion group (all P < 0.05). Conclusions The administration of L-carnitine exerts a beneficial effect upon testicular ischemia-reperfusion injury. This effect may be achieved through an induced expression of HSP70. Key words: Spermatic cord torsion; Reperfusion injury; Carnitine; Heat-shock proteins; Apoptosis

[Serum levels of pro-inflammatory cytokines in diabetic patients with peripheral neuropathic pain and the correlation among them].

Abstract: Objective To investigate the change of serum levels of the pro-inflammatory cytokines: macrophage migration inhibition factor (MIF), tumor necrosis factor-a( TNF-α), and interleukin 6 (IL-6), in patients with diabetic peripheral neuropathic pain (DPNP) and their role in the pathogenesis of related diseases. Methods Peripheral blood samples were collected from 28 patients with diabetes mellitus (DM) without complications , and gender ratio- and age-matched 32 patients with diabetic peripheral neuropathy ( DPN), 28 patients with DPNP, and 28 normal controls. Dual-antibody ELISA was used to detect the serum MIF, TNF-α, and IL -6 levels. Results The serum MIF, TNF-α, and IL-6 levels of the DM, DPN, and DPNP groups were all significantly higher than those of the control group (P 0. 05 ). There was not significant difference in the serum IL-6 level among the DM, DPN, and DPNP groups as well (all P > 0. 05). The correlation analysis show that the levels of MIF , TNF-α and IL-6 each other were positively correlated (r =0. 337, P <0. 01 ; r=0.216, P<0.001;r=0. 281,P<0. 05). Conclusions The serum pro-inflammatory cytokines MIF, TNF-α, and IL-6 levels play an important role in the pathogenesis of DM and DPN, but may not play an important role in the development of DPNP. Key words: Diabetic neuropathies; Cytokines

[Study on uric acid and the related factors associated with cognition in the patients with Parkinson's disease].

Abstract: Objective To explore the relation of cognition and uric acid in Parkinson's disease and analyze the related factors of cognition. Methods A total of 104 patients with Parkinsen's disease were divided into two groups:those with cognitive impairment and those without. Every patient was subject to the cognitive and depression function assessment. And the fasting blood uric acid samples. Then the serum uric acid levels of two groups and analyze the related factors of the cognitive with multiple linear. Results (1) The serum uric acid level in the group with cognitive impairment(249 μmol/L±59 μmol/L) is lower than that without cognitive impairment (323 μmol/L±52 μmol/L), and there was marked statistical significance (t=-6.78, P<0.001) (2) In PD patients,the cognitive scores correlated with serum uric acid levels, education, age, H-Y stages and the depression levels, but didn't with gender, disease duration, smoking and BMI. Conclusion (1) There was correlation between the serum uric acid and the cognitive impairment, Low serum uric acid level predicted worse cognitive scores. (2) In PD, the change of the cognitive function was impacted by their education, age, H-Y stages and depression levels. Key words: Parkinson's disease; Cognition; Uric acid; Related factors

[Effects of oral appliance treatment upon blood pressure in mild to moderate obstructive sleep apnea-hypopnea syndrome].

Abstract: Objective To evaluate the effects of oral appliance (OA) treatment upon systemic blood pressure (BP) in mild to moderate patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Forty-six consecutive patients diagnosed with OSAHS on polysonmography were divided into OA treatment group (OA group, 25 patients, 15 patients with hypertension) and non-tolerated OA treatment group (N-OA group, 21 patients, 13 patients with hypertension). Polysomnography and 24hour ambulatory blood pressure monitoring (ABPM) were performed at baseline in two groups.Polysomnography and ABPM were repeated after a completion of 12 weeks of treatment in OA group and after a cessation of treatment for 12 weeks in N-OA group. Hypertensive patients in two groups continued taking the same kind and the same dose of antihypertersive agents during the period of study. Results There was no significant difference between the two groups in age, body mass index, Epworth sleepiness score (ESS),apnoea-hypopnoea index (AHI), arousal index (AI) and minimum arterial oxygen saturation (MSaO2) atv baseline. After a 12-week treatment, OA group showed significant improvement in AHI [(7.0 ± 3.8) vs (21.0±6.5) per hour, P<0.01], .AI [(22.94±6.3) vs (32.2±9.3) per hour, P<0.01] and MSaO2(86.8% ±3.5% vs 80.0% ±5.2%, P<0. 01), while nocturnal mean systolic blood pressure (SBP) and diastolic blood pressure (DBP), 24-hour and diurnal SBP, and nocturnal mean artery pressure (MAP) were significantly reduced [(121.3±7.0) vs (125.3±9.3), (76. 1±6. 1) vs (78.8±6.8), (127.2 ±7.5) vs (129.4±8.8), (131.5±6.9) vs (133.64±8.1), and (91.2±6.4) vs (94.3±7.6) mmHg respectively, all P <0.01]. The reduction in nocturnal MAP was significantly correlated to improvement in AI (r = 0.37, P = 0. 005) and AHI (r = 0.32, P = 0.011), to baseline nocturnal mean blood pressure (SBP: r = 0.39, P = 0. 015 ; DBP: r = 0.30, P = 0.024). The N-OA group showed no differences in blood pressure variables between baseline and after a cessation of treatment for 12 weeks. Conclusion Oral appliance treatment for mild to moderate OSAHS may lead to a reduction in systemic blood pressure. Key words: Sleep apnea, obstructive; Hypertension; Oral appliance

Functional improvement of patients with progressive muscular dystrophy by bone marrow and umbilical cord blood mesenchymal stem cell transplantations

Abstract: Objective To investigate the feasibility of employing double transplantations of autologous bone marrow mesenchymal stem cells (BMSC) and umbilical cord mesenchymal stem cells (UMSC) in the treatment of progressive muscular dystrophy (PMD). Methods A total of 82 cases were treated by the double transplantations of BMSC and CB-MSC. They were diagnosed by clinical manifestations, CK, LDH, genetic analysis, electromyography, MRI and pathologic examination of biopsied muscle specimens from July 2007 to July 2008. Control group was self-made at before and after treatment and cases were followed up for 3-12 months, treatment method: Eighty-two patients underwent the double transplantations of bone mesenchymal stem cell (BMSC) and human umbilical cord blood MSC(CB-MSC). ① BMSC:80-150ml bone marrow sample was collected through a puncture at bilateral posterior superior lilac spine. Ficoll density gradient centrifuge was employed to separate individual monocyte for induced differentiation. ② CB-MSC: 80-160ml umbilical cord blood was harvested and processed likewise as above. ③Stem cell transplantation: Both BMSC and CB-MSC were collected and prepared into 1×108/ml and 1×107/ml cell suspension respectively. They were transplanted in divided does into the extremity muscle and vein. The clinical and laboratory parameters were monitored at 3, 6, 9 and 12 months. Results It was found that 31 cases(37.8%)obtained a remarkable efficacy, 37 cases(45.1%)were effective and 14 cases (17.1%)had no change. Total effective rate was 82.9%. Seventy patients(85.4%)felt limbs warmly, appetite improved, gained weight, had better appetite and action were nimble. Activity of daily living scale (ADL) in 72 patients (87.8%) increased as compared with pre-treatment (P < 0.01). LDH decreased at post-treatment [(475±223) u/L vs (410±216) u/L, P < 0.05, t = 6.650]. Creatine kinase [(2952±2259) u/L vs(2841±2092) u/L,P =0.223,t = 1.094] and creatine [(26±12) μmol/L vs(25±11) μmol/L,P=0.306, t = 1.029] decreased slightly. Adherence to therapy among Children and no adverse reaction was reported during the course of treatment. Conclusion The double transplantation of BMSC and CB-MSC is convenient, safe and effective in the treatment of progressive muscular dystrophy and can be considered as a new therapy of PMD. MSC represents a possible tool of cellular therapeutics for PMD. Key words: Progressive muscular dystrophy; Bone marrow; Umbilical cord blood; Mesenchymal stem cell; Transplantation

Characteristics of glycemic excursion in different subtypes of impaired glucose intolerance

Abstract: Objective To investigate the characteristics of glycemic excursion of different subtypes of glucose tolerance. Methods Assessed by oral glucose tolerance test (OGTT) repeated twice, 81 individuals were divided into 4 groups: normal glucose tolerance (NGT, n=18), isolated impaired fasting glycemia (IFG, n=12), isolated impaired glucose tolerance (IGT, n=19), combined IFG/IGT (n=11), and newly diagnosed type 2 diabetes mellitus (T2DM, n=21). And then continuous glucose monitoring system (CGMS) was used for 72 hours to monitor the blood glucose (BG) level before drug intervention. Results (1) The levels of largest amplitude of glycemic excursions (LAGE), mean blood glucose (MBG), and standard deviation of mean level of blood glucose fluctuation (SDBG) increased gradually with the deterioration of glucose tolerance. The mean amplitude of glucose excursion (MAGE) readout of the IGT group was (3.2±1.2) mmol/L , significantly higher than that of the NGT group [(1.6±0.5) mmol/L, P IGT/IFG group [(5.5±2.5)] > T2DM group [(4. 8±1.8)]. Among the three components of IGR, the IGT group showed highest MAGE (3.2±1.2) mmol/L and lowest FGE level (4.9±1.8). (2) The level of absolute mean of daily difference (MODD) increased in the following order: NGT group [(0.8±0.3) mmol/L], IGT group [(1.1±0.4) mmol/L], IFG/IGT group [(1.2±0.4) mmol/L], and T2DM group [(2.0±1.0) mmol/L] (all P<0.05). (3) The fasting glucose level deteriorated the most rapidly in the IFG group, while it reached the highest postprandial peak in the IFG/IGT group. The blood glucose curve increased along the order of NGT, I-IGT, IFG/IGT, IFG, and T2DM. (4) When the level of glycosylated hemoglobin (HbAlc) level was less than 7%, the fasting phase of curve virtually coincided with each other among individual groups with different HbAlc levels; however, the postprandial peak separated slightly. When the HbAlC level was between 7. 0% and 7.9% , the postprandial peaks of individual groups with different HbAlc levels dispersed markedly. When the HbAlc level was higher than 8% , the fasting blood glucose curve moved upwards significantly with increasing postprandial excursion. Conclusion (1) With the deterioration of glucose regulation, the intraday and day-to-day blood glucose excursions become increasingly fluctuant. (2) The amplitude of glycemic excursion is lower in the NGT group than in the T2DM group, however, the frequency of glycemic excursion is higher in the NGT subject than in the T2DM subjects. The glucose excursion profile of the IGR subjects is between the NGR and T2DM subjects. (3) The characteristics of glucose excursion of the IGT group are similar to those of the T2DM group, and the characteristics of the IFG group are similar to those of the NGT group. (4)The loss of postprandial glycemie control precedes evident deterioration in fasting phase of IGR. Key words: Diabetes mellitus; Continuous glucose monitoring; Glucose excurtion

[An association study of brain-derived neurotrophic factor gene polymorphism in bipolar disorders].

Abstract: Objective To investigate the association between brain-derived neurotrophic factor (BDNF) gene polymorphism and bipolar disorder. Methods Single nucleotide polymorphisms rs6265 and rs11030101 in BDNF gene were detected and compared between 228 patients with bipolar disorder and 361 healthy controls. Results The genotypes, alleles and combinative genotype of BDNF gene single nucleotide polymorphism rs6265 and rs11030101 did not show significant differences between two groups. There were also no significant differences in genotypes and combinative genotypes between diagnostic subtypes, genders and on-set age of bipolar disorder and controls. Conclusion This study did not found that BDNF gene single nucleotide polymorphism rs6265 and rs11030101 are associated with bipolar disorders. Key words: Brain-derived neurotrophic factor; Bipolar disorder; Single nueleotidepolymorphism

[Relationship between symptoms of pancreatic cancer-related depression and quality of life of patients].

Abstract: Objective To investigate the relationship between symptoms of pancreatic cancerrelated depression and quality of life of patients. Methods Fifty inpatients with pancreatic cancer from 3 Guangzhou hospitals between June 2007 and October 2008 were enrolled. Hamilton rating scale for depression-24 (HAMD-24) questionnaire was used to assess the degree of depression. Quality of Life (QoL) was evaluated by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30) and QLQ-PAN-26 respectively. Results Thirty-nine (78.0%) of these patients reported depression and 12 patients (30. 8%) had severe depression. The incidence of depression in pancreatic cancer patients with chemotherapy was 92.3% (24/26), which was significantly higher than that of patients with surgical therapy (62.5%, 15/24) (P = 0.011). The QoL of pancreatic cancer patients with depression in role functioning, emotional functioning and social functioning was significantly worse than that of patients without depression. The symptoms of fatigue, pain and appetite loss in pancreatic cancer patients with depression were significantly more than those without depression (P < 0.05). Conclusions Depressive symptoms are common psychological disturbance in pancreatic cancer patients. Moreover, depression significantly lowers quality of life for pancreatic cancer patients. Key words: Pancreatic neoplasms; Depression; Quality of Life

Effects of allicin on invasion and metastasis of colon cancer LoVo cell line in vitro

Abstract: Objective To study the effect of allicin on invasion and metastasis of human colon cancer cell line LoVo in vitro and furthermore elucidate its anticancer mechanisms. Methods MTT assay was used to test dynamically the effect of cell growth inhibition.The inhibitory effects of allicin on movement, adhesiveness and invasiveness of LoVo cells were evaluated by the migratory test, adhesion test and Transwell chamber experiment.Quantitative real-time reverse transcription PCR (real-time RT-PCR) was performed to quantify the mRNA expression of MMP-2, TIMP-2, CD147, VEGF, nm23-H1, HPA and uPAR. Results Allicin had inhibitive effects on growth of LoVo cells in a dose and time-dependent manner.Allicin at non-cytotoxic concentration (3 and 6μg/ml) could obviously suppress the movement, adhesion and invasive capability of LoVo cells.In the allicin-treated group(3 and 6 μg/ml), after 24 hours, the inhibition rates of migratory time were 24% and 50%(t=4.543, 12.348, P=0.010, 0.001), the inhibition rates of adhesion were 19% and 28%(t=6.145, 6.355, P=0.004, 0.003), the inhibition rates of migration were 28% and 46%(t=8.065, 28.435,both P<0.01), and the inhibition rates of invasion were 44% and 65% respectively (t=21.274, 26.288, both P<0.01).Allicin at non-cytotoxic concentration could down-regulate the mRNA levels of VEGF, uPAR and HPA in a dose-dependent manner in LoVo cells (t=7.129, 6.764, 8.497, P=0.002, 0.002, 0.001) while the mRNA levels of TIMP-2, CD147 and nm23-H1 remained basically unchanged with the same treatment (t=0.341, 1.889, 0.914, P=0.059, 0.132, 0.412).The expression of MMP-2 had not been detected in LoVo cells. Conclusion Allicin in vitro inhibits invasion and metastasis of human colon carcinoma cell LoVo at non-cytotoxic concentration through down-regulating the expression of VEGF, uPAR and HPA mRNA. Key words: Colonic neoplasms; Garlic; Cell proliferation; Cell adhesion; Neoplasm metastasis志谢江苏省淮安市科技支撑计划(HAS08009)支持

[Treatment for osteonecrosis of femoral head by hVEGF-165 gene modified marrow stromal stem cells under arthroscope].

Abstract: Objective To understand the biological characteristics and osteogenic potential of hVEGF-165 gene modified marrow stromal stem cells and investigate the effect and value of treatment for osteonecrosis of femoral head by hVEGF-165 gene modifled marrow stromal stem cells under arthroscope.Methods rAAV-2-hVEGF-165 plasmids were extracted and transfected into rabbit marrow stromal stem cells.hVEGF-165 mediated by adeno-associated virus(AAV)was used to transfect rMSCs.The transfection efficiency was detected with enhanced green fluorescent protein under fluorescence microscope.hVEGF-165mediated by adeno-associated virus(AAV)was used to transfect rMSCs.Virus transfection stayed overnight after 90% cell converged.MOI Wag 105.The transcription and expression of hVEGF-165 protein expression were detected by RT-PCR and Western blot.The necrotic bone was emptied and then MSCs were implanted under arthroscope.The histology of femoral head was inspected at postoperative 2-8 weeks.Results The expression of hVEGF-165 gene could be found distinctly in the transfected rabbit MSCs and hVEGF-165protein in the supernatants of transfected cell cultures.The transfection efficiency of adeno-associated virus (AAV)transfected rMSCs was 70%.And rAAV-2-hVEGF-165 transfected rMSCs achieved an effective expression by RT-PCR and Western blot.hVEGF-165 could be found after a 48-hour transfection and peaked at Day 10.Immunohistochemical detection showed that the implanted rMSCs was positive at Week 2 and strong positive at Week 8.The compressive strength of the hVEGF-165 gene group approached that of normal control.Conclusion hVEGF-165 gene transfected rabbit MSCs can express hVEGF-165 with highly biological activity.It provides provided a basis for employing hVEGF-165 gene and MSCs based gene therapy for ONFH repairing and regeneration.rAAV-2-hVEGF-165/MSCs may be implanted accurately under arthroscope.Implantation of human BMP-2 gene transfected BMSCs can repair early-stage experimental femoral head necrosis. Key words: Femur head necrosis; Hematopoietic stem cells transplatation; Arthroscope

[Individualized endovascular treatment of cerebral venous thrombosis: analysis of 168 patients].

Abstract: Objective To investigate the effects of individualized endovascular treatment on cerebral venous thrombosis of different types.Methods 168 patients with cerebral venous thrombosis underwent individualized endovascular treatment:direct thrombolysis via internal jugular vein in 26 cases,injection of urokinase via common carotid artery in 98 cases,stent angioplasty in venous sinus in 9,simple anticoagulant therapy in 20 cases,and treating combined intracranial hemorrhage simultaneously in 15 cases.Follow-up was conducted for 6 - 168 moths.Results Follow-up showed that the effective rate was 97.6%,recurrence rate was 6.6%,complication incidence rate was 1.2%,and death rate was 0.6%.Venous sinus recanalization occurred and primary drainage rebounded in most cases.Lateral drainage was strengthened in some cases whose venous sinuses did not recover ideally.The symptoms of most cases were alleviated along with the decrease of intracranial pressure.Conclusion Individualized endovascular treatment based on the characteristics of the disease is effective in treatment of cerebral venous thrombosis. Key words: Cerebrum; Veins ; Thrombosis; Therapeutics

[Effect of estrogen-depletion and 17beta-estradiol replacement therapy upon rat hippocampus beta-amyloid generation].

Abstract: OBJECTIVE To observe the effects of estrogen depletion and 17beta-estradiol replacement therapy upon ratbeta-amyloid (Abeta) generation and the possible related mechanisms. METHODS Rat ovaries were ectomized to mimic estrogen-depletion models and then 17beta-estradiol was administered by powdering hormone into soy-free chow as a way of replacement therapy. ELISA was carried out to detect rat hippocampus Abeta levels and alpha- and beta-secretase activities were measured after the experiment. The effects of estrogen depletion and 17beta-estradiol replacement therapy upon beta-secretase (BACE1) and neprilysin (NEP) expression were also analyzed by Western blot. RESULTS Ovariectomy significantly decreased estrogen level [(11 + or - 4) pg/ml, P < 0.01] as compared with control group [(21 + or - 8) pg/ml] while 17beta-estradiol administration increased the estrogen level [(63 + or - 13) pg/ml, P < 0.01] in blood. The Abeta40 [(28.5 + or - 4.5) ng/ml, P < 0.01] and Abeta42 [(4.5 + or - 1.2) ng/ml, P < 0.01] levels were higher in ovariectomy group as compared with their respective control group [with Abeta40 (14.4 + or - 2.4) ng/ml and Abeta42 (2.8 + or - 0.4) ng/ml respectively]. But the effects of ovariectomy on Abeta content can be partially reversed by 17beta-estradiol replacement therapy [with Abeta40 (20.3 + or - 3.2)ng/ml, P < 0.01 and Abeta42 (3.8 + or - 0.5)ng/ml, P < 0.01 respectively]. Estrogen depletion decreased alpha-secretase activity (67.5%, P < 0.01) and increased beta-secretase activity (145.8%, P < 0.01) and this effect can be blocked by 17beta-estradiol administration [with alpha-secretase activity to 90.2% (P < 0.01) and beta-secretase activity to 92.4% (P < 0.01)]. Ovariectomy increased BACE1 expression (135.4%, P < 0.01) and decreased NEP expression (40.8%, P < 0.01) and this effect can be partially antagonized by 17beta-estradiol supplementary [with BACE to 103.5% (P < 0.01) and NEP to 88.4% (P < 0.01)]. CONCLUSION Estrogen depletion can increase Abeta generation through the effects of increased beta-secretase activity and decreased alpha-secretase activity. Ovariectomy also increases BACE1 expression and decreases NEP expression. The 17beta-estradiol supplementary can decrease Abeta generation and this may to some extent explain why estrogen replacement therapy can decrease the risk of Alzheimer's disease in postmenopausal women.

Effects of Helicobacter pylori on blood glucose fluctuation in type 2 diabetic patients

Abstract: OBJECTIVE To investigate the effects of Helicobacter pylori (Hp) on blood glucose fluctuation in type 2 diabetic mellitus. METHODS 130 type 2 diabetic patients were selected, 72 patients with Hp infection and 58 without Hp infection. Relevant clinical data: blood pressure, body mass index, cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, glycosylated hemoglobin, insulin resistance index, liver function, and renal function were collected. The data of blood glucose levels at 7 time points, 6 - 7 am, 9 - 10 am, 11 - 12 am, 14 - 15 pm, 17 - 18 pm, 19 - 20 pm, and 22 - 23 pm in 3 days, totally 21 data, were collected. And input into the OTDMS data analysis software to evaluate the blood glucose fluctuation indexes: standard deviation of mean blood glucose (SDBG), mean amplitude of glycemic excursions (MAGE), large amplitude of glycemic excursions (LAGE). RESULTS There were no significant differences in age, course of disease, blood pressure, body mass index, cholesterol, triglyceride, low density lipoprotein cholesterol, glycosylated hemoglobin, and insulin resistance index between these 2 groups (all P > 0.05). The levels of MBG, SDBG, MAGE, LAGE, (mmol/L: 9.0 +/- 1.1 vs 7.6 +/- 0.5, 3.3 +/- 1.1 vs 1.7 +/- 0.5, 6.7 +/- 4.5 vs 3.0 +/- 1.1, 8.6 +/- 3.8 vs 4.2 +/- 1.5, all P < 0.05) and incidence of hypoglycemia [16.6% (12/72) vs 5.1% (3/58), P < 0.05] were all higher in the Hp positive group than in the Hp negative group. CONCLUSION Hp infection has a significant effect on the daily blood glucose level and blood glucose fluctuation in the patients with type 2 diabetes.

[Expressions of cyclinB1, FHIT and Ki-67 in 336 gastric carcinoma patients and their clinicopathologic significance].

Abstract: Objective To investigate the expressions of cyclinB1,FHIT and Ki-67 in gastric carcinoma and their clinical significance.Methods Immunohistochemistry(PV6000 method)was used to detect the expressions of cyelinB1,FHIT and Ki-67 in paraffin-embedded gastric carcinoma tissues of 336 cases and paracancerous normal mucosa of 60 cases.All cases were successfully followed up.Results The positive expression rates of cyclinB1,FHIT and Ki-67 in gastric carcinoma were 66.1%(222/336),39.9%(134/336)and 58.3%(196/336)respectively.CyclinBl and Ki-67 were all correlated with tumor size,differentiation degree,infiltrative depth,clinical stage,lymphatic invasion and distant metastasis(P ＜0.05).And FH1T showed a correlation with differentiation degree,lymphatic invasion and clinical stage (P＜0.05).The 5-year survival rate of patients with positive cyclinBl and Ki-67 expressions were both lower than those with negative expressions(P ＜0.05),whereas FHIT had the opposite pattern(P =0.025).The cyclinB1 expression in gastric carcinoma was positively correlated with the Ki-67 expression (r =0.249,P =0.0001).The expressions of cyclinB1 and Ki-67 in carcinoma were significantly higher than those in normal mucosa tissues(P ＜ 0.05),but FHIT had the opposite pattern.Ki-67 was an independent prognostic indicator for post-operative survival time.Conclusion CyclinB1,FHIT and Ki-67 may play significant roles in the occurrence and evolution of gastric carcinoma.And they can be used as useful indicators for clinical assessment of tumor biological behaviors and prognosis in patients with gastric carcinoma. Key words: Stomach neoplasms; Carcinoma; Immunohistochemistry

Effect of atorvastatin on postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting

Abstract: Objective To evaluate the effect of atorvastatin on postoperative atrial fibrillation(AF) in patients undergoing coronary artery bypass gafting(CABG)Methods A cohort of 140 consecutive patients without a history of documented AF or previous statin use,who were scheduled to undergo selective CABGwere enrolled Included patients were randomly assigned to atorvastatin group(n=71) who were administered atorvastatin 20 ms/d or to control group(n=69)After CABG,subjects were monitored continuously by electrocardiographic monitors at least 7 daysDuring the initial postoperative 7 d,the incidence and duration of AF were recordedAnd the levels of high-sensitivity C-reactive protein(hs-CRP) were meaguFed before and 24 hours,72 hours,7 days after operation,respectivelyThe statistical software package SPSS(version 130)were used to analyze the dataThe differences between groups were evaluated by χ2-test for discrete variables and student t-test for continuous variablesMultivariate logistic regression analysis was performed to determine the independent predictors of early postoperative AFResults During initial postoperative 7 d,AF occurred at least once in 10 cages in atorvastatin group,with a prevalence ofroughly 14%,and in 23 cases in control group,with a prevalence of approximately 34%(P=0009)The mean duration of single AF was 36±04 hours in atorvastatin group and 57±05 hours in control group (P＜001),respectivelyThe multivariate logistic analysis showed that perioperative atrovastatin administration was an independently risk factor for early postoperative AF(OR=0219,0076-0633,P=0005)There was also statistical difference in hs-CRP after CABG between the two groupsConclusions Perioperative atrovastatin administration may inhibit inflammatory reaction,reduce the incidenee and duration of postoperative AF,hence may prevent and treat postoperative AF Key words: Atrial fibrillation; Coronary disease; Atorvastatin

[Prevalence of and risk factors associated with diabetic retinopathy in pre-diabetic and diabetic population in Shanghai community].

Abstract: Objective To determine the prevalence and risk factors of diabetic retinopathy (DR) in the Diabetes Mellitus (DM) and impaired glucose regulation (IGR) population in Shanghai Community. Methods DR screening after the epidemiologic study of metabolic syndrome in Huayang and Canyang Community , Shanghai was conducted among 1300 patients with DM or IGR during June 2005 and March 2006, Digital non-mydriatic fundus photography was performed for each eye in all subjects. Other factors, including diabetes related history, BMI, WHR, fasting plasma glucose, HbAlc, serum lipid and blood pressure were also assessed. 642 patients,312 males and 330 females, aged 65 ± 13, with complete data were enrolled into the analysis. Results The prevalence of DR was 19. 9% in the diabetic population, and the prevalence of mild, moderate, severe non-proliferative retinopathy and proliferative retinopathy was 12. 0%, 5. 1%, 2. 3% and 0. 5%, respectively; the prevalence of DR in IGR reached 8. 0%. Logistic regression analysis revealed that HbA1c level and diabetes duration were both independently associated with diabetic retinopathy. Conclusion The prevalence of DR was high in both DM and IGR population. Bad blood glucose control and long diabetes duration both increased occurrence of DR. Key words: Diabetic retinopathy; Cross-sectional studies; Risk factors