Objective To investigate the efficacies of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery in the treatment of patients with different body mass indexes (BMI) and type 2 diabetes mellitus.Methods The clinical data of 40 patients with type 2 diabetes mellitus who underwent LRYGB surgery at the Shengjing Hospital of China Medical University from January 2013 to December 2013 were retrospectively analyzed.According to different BMI,8 patients with BMI ＜ 27.5 kg/m2 were allocated into group 1,14 patients with BMI≥27.5 kg/m2 and ＜32.5 kg/m2 in group 2 and 18 patients with BMI≥32.5 kg/m2 in group 3.Forty patients were followed up via telephone interview and food habits questionnaire by weight loss file managers of Shengjing Hospital and the fourth Affiliated Hospital of China Medical University.All the patients received the reexamination of blood test and data collection at postoperative year 1.The preoperative and postoperative 1-year fasting plasma glucose,glycosylated hemoglobin (HbA1 c),BMI and C-peptide were collected and detected.The fasting plasma glucose ＜ 7.00 mmol/L and HbA1 c ＜ 7.00％ were used as a standard of complete remission.Count data and comparison of rates were analyzed using the chi-square test.Measurement data with normal distribution were presented as x ± s and analyzed by the t test.Skew distribution data were described as M (range) and analyzed by the Wilcoxon rank sum test.Repeated measurement data were analyzed by the repeated measures ANOVA.Results Forty patients received successful LRYGB surgery without perioperative complications,and were followed up for 1 year at the Shengjing Hospital (23 patients),the fourth Affiliated Hospital (8 patients) and other hospitals (9 patients).Of the 40 patients,85.0％ (34/40) of patients had no postoperative long-term obvious malnutrition,anastomotic stenosis,ion disorders and digestive tract dynamic obstacles,15.0％ (6/40) of patients were not adapted to the change of life habits such as frequent nausea and vomiting.Five patients with different degrees of frequent vomiting,abdominal pain and night heartburn within postoperative 1 month had the remission of synptoms after symptomatic treatment.One patient in group 2 had a symptom of hypertonic coma due to intake of oral high-sugar drinks at postoperative 1 week and then was cured by hospitalization.The fasting plasma glucose,HbA1c and BMI in group 1 from preoperation to postoperation were decreased from 11.07 mmol/L (range,6.00-17.00 mmol/L) to 7.18 mmol/L (range,6.00-15.00 mmol/L),from 8.85％ (range,6.00％-11.00％) to 6.35％ (range,6.00％-9.00％) and from 26.0 kg/m2 (range,22.0-27.0 kg/m2) to 22.2 kg/m2 (range,20.0-25.0 kg/m2),with significant differences (F =2.413,3.256,6.750,P ＜ 0.05).C-peptide from preoperation to postoperation was decreased from 1.20 nmol/L (range,1.00-3.00 nmol/L) to 1.07 nmol/L (range,1.00-2.00 nmol/L),with no significant difference (F =1.678,P ＞ 0.05).The remission rate of diabetes in group 1 was 3/8.The fasting plasma glucose and HbA1c in group 2 from preoperation to postoperation were decreased respectively from 10.73 mmol/L (range,7.00-19.00 mmol/L) to 5.89 mmol/L (range,5.00-9.00 mmol/L) and from 8.00％ (range,6.00％-15.00％) to 5.85％ (range,5.00％-8.00％).The BMI from preoperation to postoperation was decreased from 31.0 kg/m2 (range,29.0-32.0 kg/m2) to 25.5 kg/m2 (range,21.0-29.0 kg/m2),with significant differences in the above 3 indexes (F =5.449,4.008,-3.296,P ＜ 0.05).C-peptide from preoperation to postoperation was decreased from 1.53 nmol/L (range,1.00-5.00 nmol/L) to 1.52 nmol/L (range,1.00-6.00 nmol/L),with no significant difference (F =-0.251,P ＞ 0.05).The remission rate of diabetes in group 2 was 10/14.The fasting plasma glucose,HbA1c and BMI in group 3 from preoperation to postoperation were decreased from 9.44 mmol/L (range,5.00-16.00 mmol/L) to 6.65 mmol/L (range,4.00-15.00 mmol/L),from 7.90％ (range,6.00％-11.00％) to 6.45％ (range,5.00％-9.00％) and from 36.9 kg/m2 (range,33.0-47.0 kg/m2) to 27.7 kg/m2 (range,23.0-34.0 kg/m2),with significant differences (F =-3.027,-3.410,-3.724,P ＜ 0.05).C-peptide from preoperation to postoperation was decreased from 2.91 nmol/L (range,0.00-9.00 nmol/L) to 2.13 nmol/L (range,0.00-6.00 nmol/L),with no significant difference (F =-3.724,P ＞ 0.05).The remission rate of diabetes in group 3 was 14/18.There was no significant difference in the remission rate of diabetes of 3 groups (x2 =4.460,P ＞ 0.05).There were significant differences in the changing trends of fasting plasma glucose and BMI among the 3 groups (F =3.200,22.500,P ＜ 0.05).There were no significant differences in the changing trends of HbA1c and C-peptide among the 3 groups (F =0.720,1.640,P ＞ 0.05).Conclusion LRYGB surgery is feasible for the treatment of type 2 diabetes mellitus with effectively decreasing fasting glucose,and should be performed on patients with BMI ≥ 27.5 kg/m2 instead of patients with BMI ＜ 27.5 kg/m2 according to a correlation of blood glucose control and preoperative BMI.

Humans ; Otorhinolaryngologic Surgical Procedures ; methods ; Quinolones ; therapeutic use ; Respiratory System Agents ; therapeutic use

Objective To investigate the clinical-pathological feature of careinoma showing thymus-like dif- ferentiation(CASTLE) of the thyroid. Methods The clinical data, histopathologie changes and immunohistoche- mical findings were studied in 1 case of carcinoma showing thymus-like differentiation of the thyroid with review of the related literature. Results The age of the patient was 38 years old. The clinical manifestation displayed a pain- less mass in the thyroid. On ultrasound the tumor appeared hypoechoic. Histologically the tumor cells were arranged in nests and islands accompanied by desmoplasfie strorna. The architecture thus showed a superficial resemblance to the lobulation seen in thymic carcinomas. The tumor was characterized by squamoid or syheytial-appearing cells with lightly eosinophilic cytoplasm. Nuciec were oval, pale to versicular, and had small distinct nudeoli. Immunohistoche- mically the tumor cells were positive for CK, CD5, CD117 but neyative for TG, Calcitonin, SYN, NSE, TTF- 1, EBV. Conclusion CASTLE is a very rate a carcinoma thyroid with architectural resemblance to thymic epithelial tumors. The immunophenolype of CASTLE is identical with that of thymie carcinoma.

BACKGROUND: Based on the characteristics of cartilage tissue, such as consisting of single type of cells, the cartilage cells or chondrocyte, absence of blood vessel, rather low consumption level of oxygen and nutrition, low level of allo-immunocompetence and simple function in vivo, it seems to be easy for cartilage cell lines to be established for tissue and cell transplantation. We want to set up a cell line with the purpose of current use in tissue engineering in vitro. It will provide the basis for artificial tissue and organ that will become to be standardized and yielded in batch.OBJECTIVE: To explore the potential stimulatory effects of basic fibroblast growth factor(bFGF) and insulin on the proliferation and differentiation in primary culture mice chondrocytes in vitro. The effect and application of the cell factors will be evaluated for tissue engineering.DESIGN: A grouping controlled and repeated trial was conducted with the cells as the subjects.SETTING: Key laboratory of tissue transplantation and immunology of a college.MATERIAIS: The experiment was completed in the Key Laboratory of Tissue Transplantation and Immunology of the Ministry of Education, Jinan University from November 2002 to May 2003. Cultured cartilage cells at random were obtained as the study objects.METHODS: Mice cartilage cells were cultured in medium at the minimum concentrations of serum. The effects of different concentration of bFGF and insulin on the proliferation and differentiation in mice cartilage cells were observed with WST1 and immunofluorescence staining.MAIN OUTCOME MEASURES: Primary results: ① Effect of bFGF on proliferation of primary cultured mice cartilage cells. ② Effect of insulin on proliferation of primary cultured mice cartilage cells. Secondary results:morphological observation of cartilage cells RESULTS: Primary cultured mice cartilage cells were cultured in medium at the minimum concentration of serum(4 g/L fatal bovine serum). It was found that bFGF and insulin might play an important role on the proliferation and growth of mice cartilage cells in a dose-dependent manner. In addition, morphological observation of cartilage cells showed that both bFGF and insulin not only promoted the proliferation of the cells but also enhanced the matrix secretion of cartilage cells.CONCLUSION: Both bFGF and insulin can stimulate the proliferation of cartilage cells in vitro.

Objective To explore the deficiency of upper limb movement in children with autism and its related factors. Methods 30 au-tism children aged 7-13 years old, and 30 healthy children aged 7-8 years from February to May, 2014 were enrolled. Their range of motion, comprehensive strength and cooperation, endurance, and muscular tension were tested. Results All the indexes of autism children lagged be-hind the healthy children (P<0.01), expect the muscular tension of the right upper limb (P>0.05). The endurance of boys was better than girls (P=0.020), and there was no difference in other aspects between them (P>0.05). The type of autism for more upper limb movement cor-related with obstruction of Jianjing acupoint (GB21) (r=0.515, P=0.013), and was significantly different with the type of less limb move-ment (χ2=8.533, P=0.003). Conclusion Compared with healthy children, the joint motion is relatively flexible, but lack of strength, and with poor persistence and unbalance development between left and right upper limbs. Motor rehabilitation should be conducted according to their movement features and the condition of meridian.

OBJECTIVE Toinvestigatethedifferenceofcytotoxiceffectsofhydroxycamptothecin(HCPT)onhuman lungcancercelsA549andhumanembryolungfibroblastcelsMRC-5.METHODS A549celsandMRC-5celswere treated with HCPT 20-200 μmol·L-1 for 24,48 and 72 h,or pulse treated with HCPT 50-400 μmol·L-1 for 24 h along with 5 d release.cellsurvival was detected by MTT assay.Morphological changes for both types of cells were observed under an inverted phase-contrast microscope.cellcycle and apoptosis in both cells treated with HCPT 50 μmol·L-1 for 48 h weredeterminedbyflowcytometry.RESULTS HCPT20-200μmol·L-1inhibitedthesurvivalofbothcelsinaconcen-tration-dependent manner and more cytotoxicity was observed in A549 cells for 48 h.The concentration-effect correlation coefficient(r)of HCPT in A549 and MRC-5 cells for 48 h was 0.898 (P=0.015)and 0.996 (P=2.56E-5)respectively. The inhibition rates were significantly different between A549 and MRC-5 cells with treatment of HCPT 20,50,80,1 00, 1 60 and 200 μmol·L-1 for 48 h (P<0.05).The IC50 of HCPT on A549 and MRC-5 cells was (24.00 ±0.69)μmol·L-1 and (1 23.63 ±3.89)μmol·L-1 respectively,indicating that A549 cells were 5-fold more sensitive to HCPT than MRC-5 cells at 48 h.After exposure to HCPT 50 μmol·L-1 for 48 h,some A549 cells were rounded up and shrank dramatical y, and some cells underwent membrane blebbing or lysing while MRC-5 cells had no obvious changes.cellcycle and apop-tosis analysis showed that A549 cells were arrested at both S and G2/M phases and apoptosis occurred but MRC-5 cells were just arrested at S phase.In the recovery growth curve,the growth of A549 cells was inhibited to a larger extent than MRC-5 cells and the growth retardation stil existed for 24 h in both cells.The survival of MRC-5 cells was faster than that ofA549cels,althoughtherewasnocompleterecoveryineithercel.CONCLUSION A549celsaremoresensitiveto HCPT than MRC-5 cells due to the fact that HCPT induces cellcycle arrest at both S and G2/M phases and apoptosis in A549 cells,but only triggers S phase arrest in the MRC-5 cells.

Objective To construct an animal model of vascularized iliac bone transplantation which could establish the immune chimerism.Methods The experiment was divided into three groups.In experiment group we slected the male SD rats as donors and the female SD rats as recipients.Then the experiment group was performed the improved vascularized ilium transplantation operation.The positive group was male SD rats without handling.The negative group was female SD rats without handling.On the twenty-eighth day after surgery, the rat SRY gene was detected by PCR.Dynamically monitoring the changes of the ratio of CD4+/CD8+ T cells by flow cytometry after operation.Dynamically monitoring the changes of the levels of serum IL-2 by enzyme linked immunosorbent assay after operation.Imaging and pathology were used to detect the transplanted iliac bone.Results Ten transplantations were performed in the experiment group and 7 flaps survived with a successful rate of 73 ％.SRY gene was detected in female rats that receive the male rats'iliac bone transplantation by PCR in the experiment group.After Micro-CT scanning and three-dimensional reconstruction, it showed that the transplanted iliac bone mineral density was decreased.Comparing rats that establish the chimerism with normal rats, the ratio of CD4 +/CD8 + T cells and the levels of serum IL-2 had no difference.Pathological results showed that the transplanted iliac bone of rats with chimerism were normal and the rats without chimerism were necrotic.Conclusions From the improved vascularized ilium transplantation operation, we successfully detected the SRY gene in female rats which received the male rats' iliac bone transplantation.It proved that the improved vascularized ilium transplantation operation could establish the chimerism.Through the immunosuppressant, the immune status of the rat after operation was well.

Objective: To observe clinical efficacy of oral folic acid (FA) intervene in hyper-homocysteinemia (HHcy) patients combining coronary artery disease (CAD) and heart failure (HF), to study the effect of blood level of Hcy on cardiac function. Methods: A total of 126 relevant patients with blood level of Hcy>15 μmol/L were randomly divided into 2 groups:Routine group, the patients received anti-platelet therapy, statins, beta-blockers, diuretics, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonist and FA group, in addition to above mentioned therapies, the patients also received FA 5 mg/day. n=63 in each group and all patients were treated for 3 months. Fasting blood levels of Hcy, BNP and left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walk test (6MWT) were compared between 2 groups at pre- and 3 months post-treatment. Results: ① Based on NYHA classification, the patients with cardiac function at II, III, IV had accordingly increased blood levels of Hcy, BNP and LVEDD, while decreased LVEF and 6MWT, all P<0.05. ② Blood levels of Hcy were positively related to BNP (r=0.733, P<0.001) and LVEDD (r=0.511, P<0.001), negatively related to LVEF (r=-0.382, P<0.001) and 6MWT (r=-0.410, P<0.001). ③ With 3 months treatment, FA group and Routine group showed decreased Hcy level as (8.43 ± 1.87) μmol/L vs (3.29 ±1.68) μmol/L and BNP (891.84 ± 456.10) pg/ml vs (682.24 ± 463.79) pg/ml, reduced LVEDD (4.33 ± 1.231) mm vs (2.06 ± 1.73) mm, while elevated LVEF (6.59 ± 2.28) % vs (2.52 ± 2.37) % and 6MWT (142.97 ± 55.15) m vs (86.35 ± 59.06) m, all P<0.05. Conclusion: Increased blood level of Hcy is risky for HF occurrence, FA may treat HHcy and further improve the cardiac structure and function in HF patients.

Objective To observe the efficacy of different degrees of portal vein ligation on portal pressure and liver regeneration of the unligated lobe in rats.Methods Seventy-two healthy male SpragueDawley rats were randomly divided into three groups:group A (sham,n =24);group B (n =24) undergoing 70％ portal vein ligation;group C (n =24) undergoing 90％ portal vein ligation.And then the portal pressure and liver regeneration rate (HRR) of the unligated lobe were detected immcdiately and postoperatively at each observation time point in each group.The serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),hepatic proliferating cell nuclear antigen (PCNA) were compared at each observation time point,and the histological changes were observed by HE staining.Results The HRR of the unligated lobe in group B and group C increased obviously postoperatively at each time point,and the HRR in group C was significantly higher than that in group B [(220.1 ± 4.3) ％,(246.3 ± 5.6) ％,(261.4 ±2.3)％ vs (128.2 ±3.7)％,(143.4 ±8.7)％,(150.7 ±7.0)％,P＜0.05].The serum ALT and AST increased obviously on day 1 and then gradually declined,and the serum ALT and AST in group C was significantly higher than those in group B on day 1 [(821.7 ± 158.3) U/L,(1 372.0 ± 376.2) U/L vs (398.6 ± 80.4) U/L,(860.4 ± 80.0) U/L,P ＜ 0.05].The immediate portal pressure in both groups were obviously increased postoperatively and then gradually declined,and the portal pressure in group C was higher than that in group B at each observation time point [(23.5 ± 1.1)cmH2O,(18.8 ±0.9)cmH2O,(17.8±1.0)cmH2O,(16.6 ±1.0)cmH2O,(15.9±1.3)cmH2O vs (17.4 ±1.0)cmH2O,(16.5 ±1.2)cmH2O,(15.3±1.0)cmH2O,(10.2±1.2)cmH2O,(10.0±1.1)cmH2O,P＜0.05].ThePCNA index in group C was higher than that in group B on day 1 and3 [(21.5 ±1.1)％,(28.2±1.3)％ vs (12.8 ± 2.1) ％,(18.8 ± 1.9) ％,P ＜ 0.05].More foca1 necrosis of the unligated lobe were observed in group C on day 1,which were more than those in group B.Conclusion Higher degree of portal vein ligation could cause higher portal pressure,which leads to the greater regeneration of the unligated lobe.

Objective To investigate the expression and clinical significance of P-selectin (CD62P) in bone marrow hematopoietic stem cells of patients with acute leukemia (AL). Methods The CD62P expression in bone marrow mononuclear cells of 15 healthy donors and 56 untreated patients with AL, were examined by flow cytometry. Results The average rate of CD62P expression was (6.72±7.64) % in hematopoietic stem cells (CD+45 CD+34 CD-38) of the 38 patients with acute myeloid leukemia (AML), was (3.46±2.51) % in hematopoietic stem cells (CD+45 CD+34 CD+19) of the 12 patients with B-acute lymphoblastic leukemia (B-ALL), and was (6.23±4.95) % in hematopoietic stem cells (CD+45 CD+34 CD+7) of 6 patients with T-acute lymphoblastic leukemia (T-ALL). The expression rates in those AL patients were higher than that in the healthy controls (1.04 ±1.23) % (t = 2.847, 3.284, 3.091, respectively, P ＜0.01), while there was no difference between the control group and the group who reach CR after routine treatment (t =1.932, P ＞0.05). Furthermore, the leukocyte,hemoglobin and platelet count in CD+62P patients with AML and T-ALL were significantly higher than CD-62P ones (t =4.153, 8.095, 8.289, 7.235, 8.692, 9.832, respectively, P ＜0.05), but there was no significant difference between CD+62P and CD-62P patients with B-ALL (t =0.340, 1.142, 0.019, respectively, P ＞0.05).Conclusion The CD62P is one of the markers of platelet activation, and its expression varies in different types of AL. The CD62P in hematopoietic stem cells of AL could be regarded as a new sign for the leukemic stem cells, as well as a helpful prognostic indicator in treatment response assessment.