Objective To study the relationship between thyroid function and disease severity or insulin resistance in patients with type 2 diabetes.Methods A total of 500 patients with type 2 diabetes and 60 normal controls were enrolled in our study.Fasting blood free three iodine thyroid original thyroid hormones(FT3) and free amino acid(FT4),thyroid stimulating hormone(TSH),thyroid related antibodies(thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb)) of two groups of selected objects were detected.In patients with type 2 diabetes group,blood insulin,glycated hemoglobin(HbA1c),and the determination of trace albumin urine creatinine(UCr) and (UMA) were assayed.Results FT3 and TSH of control group was (4.14±1.52) pmol/L,(2.10±1.33) mIU/L,but the level of case group was (4.53±0.72) pmol/L,(1.78±0.97) mIU/L respectively,the difference between case group and control group of serum FT3 and TSH were statistically significant(P=0.03,0.025).The serum FT3 significantly decreased in patients with high blood sugar,the difference between HbA1C>11% group(FT3=(3.76±0.78) pmol/l) and HbA1C≤7%(FT3=(4.37±0.78) pmol/l),7-9%(FT3=(4.24±0.62) pmol/l),9-11% (FT3=(4.36±1.68) pmol/l) groups were statistically significant(P=0.014,0.009,0.000).The higher urine MA/Cr,the more serum FT3 decreased,the difference between urine MA/Cr<30 mg/g group(FT3=(4.31±0.18) pmol/l) and 30 mg/g≤MA/Cr<300 mg/g(FT3=(4.00±0.79) pmol/l),MA/Cr≥300 mg/g (FT3=(3.50±0.76) pmol/l) groups were statistically significant(P=0.041,0.001).The differences between MA/Cr≥300 mg/g group and 30 mg/g≤MA/Cr<300 mg/g group was statistically significant(P=0.044).In addition,we found a correlation between serum TSH and insulin resistance index(HOMA-IR)(r=0.302,P=0.001).Conclusion As a sign of serious high blood sugar,it can predict the severity of diabetic nephropathy.There is intimate relationship of serum TSH and HOMA-IR.

Objective To analyze the effects of physiotherapy and manual therapy on temporomandibular disorders (TMD). Methods 90 patients with TMD were randomly divided into the medicine group (group A, n=30), physiotherapy group (group B, n=30) and physiotherapy combined with manual therapy group (group C, n=30). They were assessed with Visual Analogue Scale (VAS) of pain, maximum active mouth opening and joint clicking (100% before treatment) before and 4 weeks after treatment. Results All the patients improved in the pain after treatment (P<0.01), while the group B also improved in the maximum active mouth opening (P<0.01), and the group C improved in all the assessments (P<0.001). The result of all the assessment ranked from better to worse were group C, group B and group A (P<0.001). Conclusion Physiotherapy combined with manual therapy can improve the pain, the activity of mouth and joint clicking of TMD patients.

Objective To explore the effect of standardized comprehensive rehabilitation treatment on activities of daily living (ADL) of stroke patients. Methods 60 stroke patients were divided randomly into rehabilitation group (n=30) and control group (n=30). Both groups received routine internal medicine treatment, and the rehabilitation group received standardized comprehensive rehabilitation treatment additionally.ADL was assessed with BI at admission and 1, 2, 3 months after admission. Results In the control group, the score of BI was significantly higher 1 month after admission than at admission (P=0.000), and there was no difference 2 and 3 months after admission from 1 month after admission (P>0.05). In the rehabilitation group, the score of BI was significantly higher 1, 2 and 3 months after admission than at admission (P=0.000). There was no difference in the score of BI between 2 groups at admission (P>0.05), and the score of BI was significantly higher in the rehabilitation group than in the control group at other treatment periods (P=0.000). Conclusion Standardized comprehensive rehabilitation treatment could promote the ADL of stroke patients who have the trend of self-recovery at the early stage.

Optic nerve is composed by the axonal of retinal ganglion cells,there are no Schwann cells around it,and optic nerve belongs to the central nervous,so it cannot regenerate when injuried. In 1985 So and Aguayo have made a success in peripheral nerve retinal transplant,which completely changes the concept that optic nerve injury cannot regenarate. Currently nerve injury recovry has following several methods: use of neurotrophic factor,such as nerve growth factor,ciliary neurotrophic factor and brain-derived neurotrophic factor,etc. These factors could promote the regeneration and repair of retinal ganglion cells; treatment of gene correction and gene regulation,by changing the expression of host gene,reduce the effect due to the disease,slow the progress of the disease course or provide protection against the disease; neural stem cell transplantatin and tissue-engineered Schwann cell transplantion. But these treatments are still at the stage of animal experiment,how timely and effctively reduce the apoptosis and increase the survival rate of ganglion cells,even further promote nerve regeneration and recovery,there is still not a perfect method so far.

Objective To explore the clinical significance and safety in hemihepatectomy for hepatoma without inflow occlusion.Methods A total of 62 patients with liver cancer were divided into 2 groups.The inflow was occluded in group A (n = 28) and not occluded in group B (n = 34) during hepatectomy.Subsequently,the influence of the two approaches on the parameters including intraoperative blood loss,postoperative hepatic function and complications incidence rate was comparatively analyzed.Results Hepatectomy was successfully performed in the two groups.There was no significant difference between the two groups in intraoperative blood loss (P ＞ 0.05).Significant difference existed between the two groups in postoperative hepatic function and complications incidence rate (P ＜ 0.05).Conclusions The hemihepatectomy for hepatoma without inflow occlusion can reduce complications incidence rate and profit the recovery of postoperative hepatic function parameters.

Objective To investigate the treatment of open vertebreplasty for unstabilized thoracic-lumbar fracture. Methods From September 2003 to May 2007, there were 31 patients of thoracic-lumbar burst fracture who had undergone operation and had been followed. According to the Denis classification, all the patient were burst fracture with the involvement of middle column. All of them were undergone posterior short segment transforminal interbody fusion and vertebreplasty filled with phosphate calcium bone cement. Results All of 31 patients had undergone operation successfully. The interbody were removed when fracture healed. There was no loss of vertebral height, no degenerative change of adjacent segment. They were followed for 9～35 months, the average was 24.2 month. 2 of 31(6.4%) were found collapse of the fracture vertebrae, 1 was found kyphosis and failure fusion, which led another operation. The reason may be the severe burst of vertebrae, insufficient filling of phosphate calcium bone cement or bearing weight early stage. Of all other patients, CT scan showed sufficient decompression of fracture vertebraes, retained height of fracture vertebraes and no collapse. There was no obvious difference between height of fracture vertebrae and normal vertebrae (P0.05). The loss of correction of kyphosis was not obvious. Conclusion posterior short segment transforminal interbody fusion and vertebreplasty filled with phosphate calcium bone cement is a effective treatment for unstabilized thoracic-lumbar fracture. The pain is relieved after operation, patient can exercise on the ground in the early stage, and the quality of life is improved.

Objective To screen and isolate the radioresistance related genes of IRM-2 mice.Methods cDNA library of IRM-2 mice was constructed by SMART technique.Total RNA was isolated from spleens of IRM-2 male mice.The first-strand cDNA was synthesized by using PowerScript reverse transeriptase,and double-strand cDNA was synthesized and amplified by long PCR.The PCR products were purified,digested with restriction enzyme Sfi I.The ds-cDNA fragment lessthan 500 bp was fractionated and ligated to the Sfi I-digested pDNR-LIB vector.The ligation mixture was transformed into E.coil DH5α by electroporution transformation to generate the unamplified cDNA library.The quality of cDNA library was identified by PCR technique.130 clones from cDNA library were sequenced and compared with GenBank database.Results The cDNA library contained 2.25 x 106 independent clones with an average insert size of 1.2 kb.The ratio of recombination and full-length was 95% and 55%,respectively.21 pieces of EST sequences from cDNA library were not the same as the known mice genes and registered into GenBank EST database,with registered number DW474856-DW474876.Conclusions cDNA library of IRM-2 mice has been constructed successfully.21 pieces of EST implies that radioresistance correlative genes may be in IRM-2 mice,which will lay a foundation for isolating and identifying radioresistance related genes in further study.

Objective To investigate the clinical manifestations and imaging features of dural arterio-venous fistula of super petrosal venous drainage and treatment. Methods From May 2013 to September 2014,9 patients with petrosal vein drained dural arteriovenous fistula at the Department of Neurosurgery, Xuanwu Hospital,Capital Medical University and the Department of Neurosurgery,Beijing Haidian Hospital were enrolled retrospectively. The patients were treated with endovascular embolization or microsurgery,and the MRI and DSA examinations were improved,and the scores of the modified Aminoff&Logue scale (ALS) were performed before and after treatment. Results In the 9 patients,there were 3 females and 6 males. They all had different degrees of limb sensory and motor abnormalities,7 of them also had urination and/or bowel disorders,4 had cranial nerve dysfunction,including hoarseness,bucking,hiccup,and paralysis. Six patients received embolization treatment,3 received microsurgery,and they all achieved anatomic cure. The preoperative ALS score was 6. 0 ± 2. 7,and the score at 3 months after procedure was 2. 8 ± 1. 7. There was significant difference between before and after treatment (t=4. 816,P<0. 05). Conclusions The petrosal vein drained dural arteriovenous fistula is a kind of rare cerebrovascular malformation. The lesion involves a wide range. The clinical manifestations are severe. Both endovascular embolization and microsurgery can achieve a more ideal therapeutic effect. If the vascular condition is permitted,the interventional embolization treatment should be preferred.

Objective To explore the fixed-effects of the treatment using transarticular screw joint lateral mass screw unilateral bi-direction fixation through posterior midline approach.Methods 16 patients,12 patients with traumatic fracture-dislocation and 4 patients with cervical disc herniation with spinal stenosis,were treated with transarticular screw(caudad) joint lateral mass screw (cephalad)unilateral bi-direction fixation in the posterior cervical.Results 32 transarticular screws were implanted,including C4-5 8 pieces,C5-6 12 pieces,C6-7 12 pieces;36 lateral mass screws were implanted,including C2 13 pieces,C3 14 pieces,C4 9 pieces.All screws were successfully implanted in operation,without injuries and other complications in vertebral artery,nerve root and spinal cord.16patients were followed up for averaged 18 months ( 10 - 30 months).Surgical incisions reduced by half than traditional ,fusion time were 2.0 to 4.5 months for an average of 3.1 months.Conclusions When through theposterior fixed cervical spine,used transarticular screw joint lateral mass screw unilateral bi-direction fixation,fixed simply and reliably,reduced internal fixation materials for implantation,reduced operative time,increased bone bed area,the bone fusion rate was high,reduced the length of surgical incision,reduced the blood vessels,nerve root injury risk ,reduced complications such as axial symptoms ,saved medical expenses,achieved good results.

AIM: To investigate the effect of deoxycholic acid (DCA) on the energy metabolism in human normal colon epithelial NCM460 cells.METHODS: NCM460 cells was treated with DCA at 10, 30 and 100 μmol/L for 5 d, or DCA at 100 μmol/L for 3, 5 and 7 d.After treated with DCA at 100 μmol/L for 3 d, the cells were treated with resveratrol, the activator of sirtuin 3 (SIRT3), for the next 4 d.Adenosine triphosphate (ATP) production in the mitochondria and lactate acid level were detected.The protein expression of SIRT3 was determined by Western blot.RESULTS: DCA inhibited the ATP production, increased lactate acid level, and downregulated the protein expression of SIRT3 in a dose-and time-dependent manner.Resveratrol at 10 μmol/L reversed the effects of DCA on the NCM460 cells.CONCLUSION: DCA induces the dysfunction of energy metabolism in NCM460 cells, and the mechanism may be related with SIRT3.