A case of insulin autoimmune syndrome (IAS) is reported and the related literature reviewed. A 49 year-old male patient with Graves' disease had been on tapazole therapy for one month. There was no history of diabetes hypoglycemia and previous administration of insulin. On the morning of 21 August, 1984, at 10 a. m. the patient presented an acute episode of hypoglycemia with plasma glucose dropped to 16 mg/dl and was relieved with I.V. glucose. Clinical investigations revealed fasting hypoglycemia, impaired glucose tolerance and postprandial hypoglucomia. There was a large amount of spontaneously occurred insulin antibody in the serum of the patient. After pretreatment with PEG, the measurements of plasma free insulin revealed fasting hyperinsulinemia and lack of insulin release peak after glucose loading. Immunological studies showed the presence of autoantibodies against insulin, TSH receptors, thyroid microsomes and pituitary cells. One month later the fasting hypoglycemia disappeared, the glucose tolerance test became normal and the amount of insulin autoantiboy markedly decreased.

0.05).Conclusion:Anesthesia with a little dose of midazolam or propofel combined with fentanyl can be applied to the repair of of cleft lip in infants(

0.05).For the time points of cutting skin(T2)?exploring biliary tract(T3) and pulling out endotracheal catheter(T4),MAP and HR in group A were higher than those in group B(P

Objective To improve the diagnosis and treatment of hermaphroditism.Methods The data of 138 cases of hermaphroditism who were hospitalized in our department between March 2005 and April 2008 were reviewed and and analyzed to summarize our experience in the diagnosis and treatment.Results Among the 138 cases with a age ranging from 2 to 36(mean 17 years old),42 were socially male and 96 were socially female.With the help of medical examination,,laboratory examination,ultrasonic examination,radiological examination and pathologic diagnosis,54 patients were diagnosed as female pseudohermaphroditism,66 as male pseudohermaphroditism,10 patients as true hermaphroditism,2 patients as pure gonadal dysgenesis,2 as testicle degeneration,and the left 4 patients as Klinefelter syndrome.Among the 138 patients,132 patients were received surgery operation,including 76 of them receiving laparoscopy.After operation,121 patients were maintained female sex,11 patients were maintained male sex.Female pseudohermaphroditism were all maintained female sex.Fifty-nine patients of male pseudohermaphroditism were maintained female sex.There were 4 patients being maintained male sex,and 3 patients having not received operation.Of the cases of the true hermaphroditism,8 patients were maintained female sex and 2 patients were maintained male sex.Conclusion Early accurate diagnosis is very important to the treatment of hermaphroditism.Etiologic diagnosis is useful in the course.Although it is good for the hermaphroditism to maintain female sex,the decision of the patients and the family should be considered.

Objective To evaluate the efficacy and adverse effect of brachial plexus block with morphine and ropivacaine for postoperative analgesia in children. Methods Forty-five children undergone upper extremity surgery were randomly divided into three groups (n = 15) , ie, Croup A (brachial plexus block with ropivacaine), Croup B (brachial plexus block with ropivacaine and subcutaneous injection of morphine) and Croup C (brachial plexus block with morphine and ropivacaine). The analgesic effect and the analgesia maintenance time were recorded by FLACC method at 1, 2, 4, 6, 8, 12, 24 hours after operation. The adverse reactions were observed 48 hours after operation. Results There was no statistical difference between Croup A and Croup B in the analgesia maintenance time and the number of cases without analgesic therapy at each time point (P > 0. 05). Compared with Croup A or Croup B, the analgesia maintenance time in Croup C were significantly extended and the number of cases without analgesic therapy at 4, 6, 8, 12, 24 hours after operation were significantly increased (P < 0.05). The adverse effect was fairly light in three groups. Conclusion Brachial plexus block with morphine and ropivacaine may extend analgesia maintenance time effectively and safely in children undergone upper extremity surgery.

The fermentation of ?-mannanase from an alkaliphilic Bacillus sp. has been studied in 16L tank. The optimum ventilation quantity and agitation speed were 1:1 vvm and 500r/min respectively. The fermentation cycle was 40 h and the highest ?- mannanase activity was 300 u/ml.

Objective To evaluate the effect of Shenfu Decoction pretreatment on the function of intestinal mucosal barrier of endotoxemic rats.Methods Twenty-four adult male Sprague-Dawley rats,aged 4-6 months,weighing 180-220 g,were randomly divided into 3 groups (n =8 each):blank control group (group C),endotoxemia group (group E) and Shenfu Decoction pretreatment group (group S).Endotoxemia was induced by lipopolysaccharide 10 mg/kg injected intravenously in anesthetized rats in groups E and S.Normal saline and Shenfu Decoction 5 ml/kg were injected intraperitoneally at 30 min before the model of endotoxemia was established in groups E and S,respectively.At 2 h after the model of endotoxemia was estabhshed,blood samples were obtained from the abdominal aorta for measurement of the plasma concentrations of tumor necrosis factor-α (TNF-α),interleukin6 (IL-6),intestinal fatty acid binding protein (i-FABP) and diamine oxidase (DAO) by ELISA.The distal ileum was harvested for detection of the expression of tight junctional protein Zonula Occludens-1 (ZO-1) in the intestinal mucosa of epithelial cells by immunohistochemistry.The changes in pathological morphology of the intestinal mucosa were examined after one segment of the distal ileum was stained with haematoxylin and eosin.The pathological changes were assessed and graded according to Chiu's score.Results Compared withgroup C,the plasma TNF-α,IL-6,i-FABP and D-lac concentrations were significantly increased,Chiu's scores were increased,and the expression of ZO-1 was down-regulated in groups E and S (P ＜ 0.05).Compared with group E,the plasma TNF-α and IL-6 concentrations were significantly decreased,the plasma i-FABP and D-lac concentrations were decreased,Chiu's scores were decreased,and the expression of ZO-1 was up-regulated in group S (P ＜ 0.05).Conclusion Shenfu Decoction pretreatment can attenuate the damage to the intestinal mucosa and protect the function of intestinal mucosal barrier in endotoxemic rats and inhibition of systemic inflammatory responses is involved in the mechanism.

An ultrasensitive immunoassay was developed based on As3+ and Hg2+ labeled SiO2 @ Au nanoparticles signal tags and hydride generation-atomic fluorescence spectrometry (HG-AFS) for the detection of carcinoembryonic antigen(CEA) and carbohydrate antigen 19-9 (CA 19-9) respectively. Firstly, amino SiO2@ Au NPs were synthesized for selective absorption of As3+ and Hg2+ ions respectively. Subsequently,the secondary antibody (Ab2) of CEA and CA 19-9 was respectively labeled on As3+ or Hg2+-SiO2 @ Au NPs to prepare the corresponding signal tags for CEA and CA 19-9. Based on the sandwich immunoassay scheme, the tags, two antigen and corresponding first antibodies were bio-conjugated on the bottom of 96-well plate at room temperature to form the immunocomplex. After it was dissolved in alkali solution, As3+ and Hg2+ ions were released in solution and detected by HG-AFS, which concentration was proportional with logarithms of CEA and CA 19-9. The reaction conditions were optimized and the tags were characterized. This assay was based on determination of the concentration of As3+ and Hg2+ for quantization of the corresponding CEA and CA 19-9 antigen. The assay showed a wide linear range from 0. 001 to 100. 0 μg / L for CEA and 0. 01-80 U/ mL for CA 19-9, and a lower detection limit of 0. 5 ng / L and 0. 005 U/ mL respectively. This proposed method was used in real serums samples, the results were consistence with that by ELISA. The immunoassay showed three orders of magnitude of sensitivity lower than that of ELISA, which provides a promising simultaneous immunoassay for the early diagnosis of cancer .

Objective: To understand and compare the differences in help-seeking behavior among junior high school students and senior high school students and their association with non-suicidal self-injury to provide a basis for the prevention and control of non-suicidal self-injury among middle school students. Methods: Three middle schools in Nanchang were selected,and the survey were conducted among 4 434 students through the General Situation Questionnaire, the Ottawa Self-injury Judgment Entry, and the Middle School Students Help Seeking Behavior Questionnaire, and SPSS 22.0 was used for statistical analysis. Results: The NSSI detection rate among middle school students was 33.3% , and junior high school students detection rate(36.0%) were higher than high school students(29.6%) (χ 2=19.41，P<0.01). Differences in willingness to ask for help, asking for help from family and teachers, and talking face-to-face for help were statistically significant (all P<0.01) among NSSI participants and non-NSSI participants, for both junior high school and high school students. Females (OR=1.45), class cadres (OR=1.26), urban household registration (OR=1.45), frequent scolding by elders (OR=1.98) and a high academic burden (OR=1.39) all possible increased the risk of NSSI in junior high school students, while assistance to family members (OR=0.95) or teachers (OR=0.95) possible reduced the risk of NSSI in junior high school students. Females (OR=1.50), class cadres (OR=1.34), only children (OR=1.45), fathers with college education and above (compared to junior high school and below) (OR=1.56), frequent scolding by elders (OR=2.08), frequent corporal punishment from elders (OR=4.12) and high academic burden (OR=1.38) possibly increased the risk of NSSI among high school students, while willingness to ask for help (OR=0.82), asking for help from family (OR=0.95) and teachers (OR=0.96) possible reduced the risk of NSSI among high school students. Conclusion There are some differences in help-seeking behavior between junior and high school students, and school and parents should actively focus on middle school students help-seeking behavior and encourage them to seek help.

BACKGROUND:Titanium and its alloys are widely used in orthopedic implants due to their excellent biocompatibility,corrosion resistance,and mechanical properties.However,it has biological inertia itself,cannot provide a good growth environment for osteoblasts,and it is difficult to form good osseointegration. OBJECTIVE:To construct a composite hydrogel material of gelatin methacryloyl and polyacrylamide on the surface of titanium alloy scaffold,and analyze its osteogenic ability in vitro. METHODS:Gelatin methacryloyl was mixed with acrylamide.Crosslinking agent and catalyst were added to synthesize gelatin methacryloyl and acrylamide(Gelma-PAAM)composite hydrogel.The titanium alloy scaffold modified by affinity silane was mixed with the Gelma hydrogel and Gelma-PAAM composite hydrogel to complete the loading(recorded as Ti-Gelma and Ti-Gelma-PAAM,respectively).The swelling ratio and degradation rate of the two hydrogels on the surface of the scaffold were compared.The bonding state between hydrogels and titanium alloy was observed by scanning electron microscope.Rat bone marrow mesenchymal stem cells were inoculated into Ti,Ti-Gelma and Ti-Gelma-PAAM scaffolds,separately.Cell proliferation,adhesion,and osteogenic differentiation were detected. RESULTS AND CONCLUSION:(1)Compared with Gelma hydrogel,Gelma-PAAM hydrogel had higher swelling rate and lower degradation rate.(2)Scanning electron microscope showed that the surface of the two kinds of hydrogels was honeycomb structure.After being combined with porous titanium alloy scaffold,the film was wrapped on the surface of scaffold and filled with pores.Among them,the Gelma-PAAM composite hydrogel coated the scaffold more fully.(3)CCK-8 assay and live/dead fluorescence staining showed that bone marrow mesenchymal stem cells proliferated well after coculture with Ti-Gelma and Ti-Gelma-PAAM scaffolds and maintained high activity.After osteogenic induction culture,alkaline phosphatase activity,calcium deposition,and osteogenic gene expression of cells of titanium alloy scaffold group were the lowest,and alkaline phosphatase activity,calcium deposition,and osteogenic gene expression of cells of Ti-Gelma-PAAM scaffold group were the highest.(4)Phalloidin cytoskeletal staining exhibited that the cells of pure titanium alloy scaffold group and Ti-Gelma scaffold group were sparse and insufficiently extended,while the cells of Ti-Gelatin-PAAM group had the most adequate stretching and the densest filamentous actin.(5)The results show that Gelma-PAAM hydrogel has good biocompatibility and osteogenic ability,and is more suitable for osteogenic modification on the surface of titanium alloy than Gelma hydrogel.