Objective To investigate onthe correlation between the seven single nucleotide polymorphisms and genesis of T2DM. Methods High‐resolution melting (HRM ) curve technology was used to detect thegenotype of the seven SNPs in 202 T2DM patients and 200 healthy volunteers. The relationship between susceptible gene polymorphism and T 2DM was analyzed. Results The frequency of five SNP loci rs8050136 ,rs13266634 ,rs7578597 ,rs864745 and rs7961581 showed significant differences between T2DM patients and controls ( P< 0.01 ). The OR of rs8050136 ,rs13266634 ,rs757859 and rs864745 was >1 ,while OR of rs7961581 was <1. There was no significant difference in rs10811661 and rs10923931 loci between T2DM patients and controls (OR=1). Conclusion The polymorphism of loci rs8050136 ,rs13266634 ,rs7578597 and rs864745 is associated with T2DM genesis in this study population , while rs10811661 and rs10923931 is not associated with T 2DM genesis ,and rs7961581 may be a protective factor for T2DM.

Retrospective analysis was performed on the preoperative imaging examinations in 18 patients with primary hyperparathyroidism (PHPT). The results showed that non-invasive imaging examinations such as B ultrasound, CT, MRI and ~(99m)Tc-MIBI radionuclide scanning were of great value in locating the lesions of PHPT, ~(99m)Tc-MIBI radionuclide scanning is recommended as the method of first choice.

Objective:To establish the methods for the qualitative identification and content determination of aurantio-obtusin and chrysophanol in Zeju Jiangzhi tablets. Methods:A TLC method was adopted for the qualitative identification, and an HPLC method was used for the content determination. The determination was performed on a Wondasil C18 (250 mm × 4. 6 mm, 5 μm ) column with the mobile phase of acetonitrile -0. 1% phosphonic acid with gradient elution at the flow rate of 1. 0 ml?min-1 , the detection wave-length was 286 nm, the column temperature was 30℃ and the injection volume was 10μl. Results:The TLC spots of aurantio-obtusin and chrysophanol were clear and well-separated without any negative interference. The HPLC experiment results showed the good line-arity within the range of 1. 03-25. 72μg?ml-1(r=0. 999 9) for aurantio-obtusin, and 0. 48-11. 92μg?ml-1(r=0. 999 9) for chry-sophanol. The average recovery was 99. 21% and 98. 85%, and RSD was 0. 70% and 0. 73%, respectively (n=9). Conclusion:The method is simple, accurate and repeatable, which can be used for the qualitative identification and content determination of auran-tio-obtusin and chrysophanol in Zeju Jiangzhi tablets.

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus (T2D) and their clinical correlation were investigated. We recruited 43 T2D patients and 20 age-matched healthy subjects. Plasma myostatin, lipid and glucose, and serum insulin were determined. T2D patients showed significantly higher fasting plasma glucose (FPG), serum insulin and triglyceride levels, and lower high-density lipoprotein levels than normal control subjects (P<0.01). Mean plasma myostatin level in T2D patients and health controls was (66.5±17.8) and (46.2±13.8) ng/mL, respectively. An unpaired t test showed that the increase of myostatin in the T2D patients was significant (P<0.001). In both healthy control and T2D groups, the female subjects showed higher myostatin levels than the male subjects. In the T2D patients, plasma level of myostatin was negatively correlated with body mass index (BMI, r=-0.42, P<0.01) and FPG (r=-0.51, P[Symbol: see text]0.01), but positively correlated with insulin resistance index (HOMA-IR, r=0.48, P<0.01). Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI, FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease. Furthermore, circulating myostatin levels may be used as a biomarker for the disease.

Objective: To investigate the potential risk factors for influencing renal recovery at discharge in critically ill patients with acute kidney injury (AKI) requiringcontinuous renal replacement therapy (CRRT). Methods: This was a single-center, retrospective study. Critically ill patients with AKI requiring CRRT adimitted to the Department of Intensive Care Unit (ICU) in Taizhou Municipal Hospital, Zhejiang province, from June 2014 to December 2017 were included and divided into two groups according to the status of renal recovery at discharge as renal recovery group and renal non-recovery group. The data of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score and sequential organ failure assessment (SOFA) score at adimission to ICU, initial serum creatinine (initial SCr) and lactate level and initial estimated glomerular filtration rate (initial eGFR) at time of AKI diagnosis, and total time of RRT and duration of anuria before CRRT were analyzed. Length of ICU stay and length of hospital stay in both groups were also analyzed. Multivariate logistic regression was taken to analyze the potential risk factors for influencing renal recovery at discharge in critically ill patients with AKI. Results: A total of 115 critically ill patients with AKI requiring CRRT were included, of which whom 45 cases were in renal recovery group and 70 cases were in renal non-recovery group, and the renal recovery rate at discharge was 39.1%(45/115); 59 patients were dead during hospitalization and the hospital mortality was 51.3%(59/115). Compared with renal non-recovery group, renal recovery group have a lower value of APACHEⅡ score [(21.73 ± 2.66) scores vs. (23.19 ± 4.41) scores, P=0.03), SOFA score [(11.02 ± 2.22) scores vs. (12.79 ± 2.82) scores, P=0.001], lactate level [(3.82 ± 1.34) mmol/L vs. (4.47 ± 1.52) mmol/L, P=0.021], initial SCr [(2.151 ± 0.677) mg/dl vs. (2.505 ± 0.792) mg/dl, P=0.015], duration of anuria before CRRT[(11.80 ± 4.71) h vs. (19.11 ± 5.98) h, P=0.005] and total time of RRT [(8.64 ± 3.42) d vs. (15.81 ± 5.07) d, P=0.001], and have a higher value of initial eGFR [(36.26 ± 14.74) ml/(min·1.73 m²) vs. (30.07 ± 10.38) ml/(min·1.73 m²), P=0.009]. In addition, length of ICU stay [(12.58 ± 4.78) d vs. (15.30 ± 5.45) d, P=0.007] and length of hospital stay [(19.58 ± 6.44) d vs. (22.11 ± 5.90) d, P=0.032] in renal recovery group were also significantly lower than those in renal non-recovery group. Multivariate logistic regression analysis indicated that SOFA score (OR=0.700, 95% CI 0.521-0.941, P=0.018), duration of anuria before CRRT (OR=0.782, 95%CI 0.689-0.888,P < 0.01) and total time of RRT (OR=0.673, 95% CI 0.565-0.801; P < 0.01) were independent risk factors influencing renal recovery at discharge in critically ill patients with AKI, and initial eGFR was a independent protective factor. Conclusions As to critically ill patients with AKI requiring CRRT, there are many factors that affect renal recovery at discharge,. SOFA score, duration of anuria before CRRT and total time of RRT are independent risk factors, and initial eGFR is an independent protective factor.

OBJECTIVETo investigate the influence of different pressures of CO2 pneumoperitioneum on pathomorphism and function of intestines following laparoscopic gastrectomy (LG).

METHODSForty-eight gastric cancer patients were prospectively enrolled in the study. Among them, 36 patients scheduled for elective LG were randomly assigned to low pressure group (LP), middle pressure (MP), and high pressure group (HP) with 12 cases in each group. The CO2 pneumoperitoneum pressure was maintained at 8-10 mmhg in LP, 11-13 mmhg in MP, and 14-16 mmhg in HP. The control group was open gastrectomy group (OG) in 12 cases. The intestinal pathomorphism and level of plasma D-lactic acid before, during and after operation, and postoperative intestinal function of four groups were examined and compared.

RESULTSThere were no statistical differences in preoperative data among the four groups(all P>0.05). LG group was associated with a lower rate of surgical complications than OG (8.3% vs. 41.7%, P<0.05). No obvious damage of intestinal mucosa was found in OG group. Damage degree of intestinal mucosa after operation in LP, MP and HP groups was 0-1, 1-2, and 2-3 respectively. There was significant change in intestinal pathomorphism after operation in both HP and MP groups. The levels of D-lactic acid before operation were not significantly different among all the four groups, but increased significantly in each group after operation (all P<0.05). HP group had the highest level of plasma D-lactic acid and presented with delayed bowel sound return (4.5 d), time to first flatus (5.4 d), and intake (6.0 d) as compared to the other 3 groups (all P<0.05).

CONCLUSIONSLaparoscopic radical gastrectomy is safe and minimally invasive. Higher pneumoperitoneal pressure is harmful to the recovery of intestinal mucosa and function. Therefore the pneumoperitioneum pressure should be maintained as low as possible under clear visualization during operation.

Gastrectomy ; Humans ; Intestines ; physiology ; Laparoscopy ; Pressure ; Stomach Neoplasms ; surgery

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus (T2D) and their clinical correlation were investigated. We recruited 43 T2D patients and 20 age-matched healthy subjects. Plasma myostatin, lipid and glucose, and serum insulin were determined. T2D patients showed significantly higher fasting plasma glucose (FPG), serum insulin and triglyceride levels, and lower high-density lipoprotein levels than normal control subjects (P<0.01). Mean plasma myostatin level in T2D patients and health controls was (66.5±17.8) and (46.2±13.8) ng/mL, respectively. An unpaired t test showed that the increase of myostatin in the T2D patients was significant (P<0.001). In both healthy control and T2D groups, the female subjects showed higher myostatin levels than the male subjects. In the T2D patients, plasma level of myostatin was negatively correlated with body mass index (BMI, r=-0.42, P<0.01) and FPG (r=-0.51, P[Symbol: see text]0.01), but positively correlated with insulin resistance index (HOMA-IR, r=0.48, P<0.01). Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI, FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease. Furthermore, circulating myostatin levels may be used as a biomarker for the disease.
Blood Glucose ; Diabetes Mellitus, Type 2 ; blood ; Female ; Humans ; Insulin ; blood ; Lipids ; blood ; Male ; Middle Aged ; Myostatin ; blood

Objective Using middle cerebral artery occlusion (MCAO) model to observe protective effect of effective components of bezoar on brain damage.To discuss the anti-cerebral ischemia mechanism and compare the efficacy of effective components of bezoar from the endoplasmic reticulum stress intervention angle.Methods Rats were stratified randomly divided into sham group,model group,Qingkailing group (positive drug,3 mL/kg),taurine group,ursodeoxycholic acid (UDCA,78 mg/kg) group,taurine-conjugated ursodeoxycholic acid (TUDCA,100 mg/kg) group.Through establish MCAO model in rats,observed the scores of the neurologic impairment,measured infarct volume by TTC.Immunohistochemistry and Western blotting were Used to detect the content of P-PERK,P-EIF2α,and ATF4.Results Compared with sham group,neurologic impairment scores of model group significantly reduced (P ＜ 0.01).Compared with model group,Qingkailing group,UDCA group,and TUDCA group significantly improved neurological function in rats (P ＜ 0.05,0.01).Compared model group,all the treatment groups could significantly reduce the volume of cerebral infarction (P ＜ 0.01).Compared with sham group,expression of P-PERK,P-EIF2α,and ATF4 was significantly increased (P ＜ 0.01).Compared with model group,all the treatment groups reduced the expression of P-PERK,P-EIF2α,and ATF4 in varying degrees,effect of Qingkailing and TUDCA were more obvious.Conclusion The effective components ofbezoar alleviate cerebral ischemia reperfusion injury in rats by inhibiting endoplasmic reticulum stress,the effect of TUDCA is better than that of taurine and UDCA.

OBJECTIVETo identify the risk factors associated with the severity of pulmonary embolism among patients with deep venous thrombosis of lower extremities.

METHODSThis prospective study enrolled 208 patients with acute deep venous thrombosis to screen for pulmonary embolism between July 2010 and July 2012 in Beijing Shijitan Hospital. There were 101 male and 107 female patients, with a mean age of (59 ± 16) years. Gender, age, extension, side of lower extremities of deep venous thrombosis was analyzed by χ² test. Ordinal Logistic regression was used to determine risk factors associated with severity of pulmonary embolism.

RESULTSThere were 83 patients with iliofemoral deep venous thrombosis, 102 patients with femoropopliteal and 23 patients with calf deep venous thrombosis. Pulmonary embolism was detected in 70 patients with the incidence of 33.7%. Pulmonary embolism was significantly correlated with extension (χ² = 17.286, P = 0.004) and sides (χ² = 15.602, P = 0.008) of deep venous thrombosis, not with age (χ² = 7.099, P = 0.260), gender (χ² = 7.014, P = 0.067), thrombotic risk factors (χ² = 3.335, P = 0.345) in univariate analysis. Results of multivariate ordinal logistic regression showed that iliofemoral vein thrombosis (OR = 6.172, 95% CI: 1.590 to 23.975, P = 0.009) and bilateral venous thrombosis (OR = 7.140, 95% CI: 2.406 to 24.730, P = 0.001) are associated with more serious pulmonary embolism.

CONCLUSIONSIncidence of pulmonary embolism is still high in patients with deep venous thrombosis. Extensive iliofemoral and bilateral vein thrombosis may increase risk of severity of pulmonary embolism. Clinicians should pay more attention to these high-risk patients.

Acute Disease ; Adult ; Aged ; Female ; Humans ; Incidence ; Logistic Models ; Lower Extremity ; pathology ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Embolism ; diagnosis ; pathology ; Risk Factors ; Veins ; pathology ; Venous Thrombosis ; diagnosis ; pathology