The effect of RNA interference-mediated adiponectin gene silence on glucose-lipid metabolism in apolipoprotein E gene knock-out(ApoE~(-/-)) mice was studied. The plasma adiponectin level in ApoE~(-/-) mice with high-fat diet and adiponectin short hairpin RNA (shRNA) adenovirus injection (ADI group) was significantly lower than that in ApoE~(-/-)mice with high-fat diet(HF group), normal-chow(NF group)and naked adenovirus injection (GF, both P<0.01). Fasting blood glucose, fasting plasma insulin, free fatty acids, total cholesterol, triglycerides, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and body weight were significandy elevated in three high-fat diet groups compared with in NF group, (P<0.01). However, fasting plasma insulin, free fatty acids, total cholesterol, triglycerides, LDL-C, and HDL-C in ADI group were significantly higher than those in HF and GF groups(P<0.01 or P<0. 05). A typical clinical phenotype of glucose-lipid metabolism and insulin resistance in ApoE~(-/-) mice can be induced by high-fat feeding and adiponecting gene silencing.

Objective To investigate the method and effectiveness of the digital artery series and parallel of island flap for repairing degloved injuries of the fingertip of thumb or adjacent finger Methods Between September 2008 and July 2012,the finger artery series retrograde island flaps tiled in the repair of finger degloving injury in 13 cases,repair of adjacent finger tip degloving injury in 11 cases; 8 cases of degloved injuries of the fingertip were tiled with the digital artery parallel island flap from ulnaris middle finger and radialis ring finger of arteria digitalis communis pedicled which were from the same palm side.The size of skin and soft tissue defect ranged from 2.0 cm × 1.8 cm-7.2 cm ×5.5 cm,gutted flap minimum ranged from 1.1 cm × 1.0cm-1.5 cm × 1.3cm,and the maximum ranged from 3.0 cm × 2.2 cm-5.5 cm × 4.5 cm.The donor sites were repaired with the intermediate split thickness free skin grafts and performed with pressure dressing.Results The group of 32 cases,in 1 case the flap vasospasm occurred in operation of free process,the symptoms disappeared after local application of papaverine and hot compress ; 1 case of flap occurred disturbance of blood circulation after operation because of tight suturing for pedicle,the symptoms relieved after removing the stitches at intervals; 2 cases blisters appeared after operation,disappeared after a week.All skin flaps were survived,incision and skin graft donor sites healed by first intention.Twenty patients were followed-up from 6 to 12 months after operation.All flaps presented the satisfactory appearance and texture,recovered protective feeling.At last follow-up,the two-point discrimination was 7 to 10mm,and the flexion and extension function of wounded fingers recovered to normal.According to the functional assessment criteria of upper limb formulated by the Hand Surgery Branch of Chinese Medical Association,there were excellent in 19 cases,good in 10 cases,and moderate in 3 cases.No significant loss to the donor shape and function.Conclusion The surgery by adopted the digital artery series or parallel of island flap for repairing degloved injuries of the fingertip of thumb or adjacent finger,not only has the advantages of simpleness,safety and reliability,but also can satisfy the patients who aren't willing to accept or because of physical reasons can't accept the treatment of abdominal skin tube or nail flap from hallux toe,which performs in both high-end and low level hospitals,and deserves of general application.

Objective: To develop a simple LC MS/MS method for the measurement of limonin in fructus evodiae, cortex phellodendri, cortex dictamni and its preparation. Methods: Separation was obtained by using a discovery C 18 column (150mm?2.1 mm), The mobile phase:A:water-0.1%HAc;B:acetonitrile-0.1%HAc;The elution program was gradient and the flow rate was 0.2mL?min -1 . The mass detector was set MS1(IS)=187.0 and MS2(Limonin)=471.0 by multiple reaction monitor(MRM) respectively.The sample was added psoralen(IS), then extracted with methanol chloroform(1∶3).Results: Limonin was linear from 25 to 1000ng?mL -1 ( r = 0.9996), The regression equation was C=3.124 As/Ai 1.935?10 -3 . The average recovery was 100.2%.Conclusion: This method is simple, quick, sensitive and exclusive.

Objective To investigate the incidence and etiological factors of hyponatremia following traumatic brain injury (TBI) and analyze the relationship between hyponatremia and the patient’s age, gender, type of injury, Glasgow coma scale (GCS), operation and computerized tomography (CT) scan of head. Methods Clinical data of 136 pa-tients with moderate or severe TBI in our hospital were analyzed retrospectively, including patient’s age, gender, type of injury, GCS, operation, brain edema and basal skull fracture. The relationship between clinical data and hyponatremia were analyzed statistically by Chi-square test and multivariate Logistic regression analysis. Results There were 56 pa-tients with hyponatremia in 136 patients (81 males) with moderate or severe TBI. Multivariate Logistic regression analysis showed that hyponatremia secondary to TBI was not associated with patient’s age, gender, type of injury and operation or not. However, there was a high correlation between hyponatremia following TBI and clinical characteristics of TBI at ear-ly stage, such as GCS, brain edema and basal skull fracture. Conclusions Patients with TBI is more likely to develop hy-ponatremia when they have the following clinical factors, such as GCS≤8, brain edema or basal skull fracture. Preven-tive measures should be given to these patients in advance.

Plasma nesfatin-1 levels were assayed by ELISA in patients with impaired glucose regulation (IGR),type 2 diabetes mellitus( T2DM ),and healthy subjects with normal glucose tolerance( control group).The results showed that plasma nesfatin-1 levels in IGR and T2DM groups were significantly higher than that in control group [ ( 1.91 ±0.79 and 1.80±0.80 vs 1.41 ±0.58) μg/L,P＜0.01 ].Plasma nesfatin-1 levels were positively correlated with body mass index(BMI),HbA1c,waist hip ratio,fasting plasma glucose,fasting insulin,and homoestasis model assessment insulin resistant index( HOMA-IR,P＜0.05 or P＜0.01 ).Multiple regression analysis showed that BMI and HOMA-IR were independent related factors in influencing plasma nesfatin-1 levels (both P＜0.01 ).These results suggest that nesfatin-1 may partially contribute to the pathogenesis of insulin resistance and T2DM.

Objective To investigate the effects of liraglutide on glucose-lipid metabolism in ApoE-/-mice with RNAi-mediated adiponectin gene inhibition. Methods The dose-effective relationship of liraglutide was evaluated by intravenous glucose tolerance test (IVGTT), and the insulin sensitivity and glucose-lipid metabolism were assessed by the hyperinsulinemic-euglycemic clamp technique using 3-[3 H]-glucose as a tracer. Results In the IVGTT, blood glucose was significantly lower in the 1 mg/kg liraglutide group than that in other groups ( all P＜0. 01 ) at the points of 5, 15, and 30 min after glucose load. However, plasma insulin was significantly higher at the points of 5 and 15 min (all P＜0. 01 ). Fasting blood glucose (FBG), body weight, free fatty acids (FFA),total cholesterol, triglycerides, low-density lipoprotein-cholesterol ( LDL-C), and fasting plasma insulin in ApoE-/-mice with co-injection of liraglutide and adiponectin shRNA adenovirus ( HEA group ) were significantly lower than those in ApoE-/-mice with adiponectin shRNA adenovirus injection ( ADI group, P＜0. 05 or P＜0. 01 ). However,high-density lipoprotein-cholesterol (HDL-C) was significantly higher than the latter (P＜0. 05 ). During the steady-state of clamp, plasma insulin in ADI group was significantly higher than that in HEA group (P＜0. 01 ). Although FFA, total cholesterol, and triglycerides were suppressed in all groups, they were still higher in ADI group than those in HEA group (P＜0. 05). Glucose infusion rate (GIR) in HEA group were significantly higher than that in ADI group ( P ＜ 0. 01 ). At the end of clamp, glucose disappearance rate ( GRd ) was significantly lower, and hepatic glucose production significantly higher in ADI group than those in HEA group (P＜0.01 ). Conclusion Administration of liraglutide may ameliorate insulin resistance via increasing plasma adiponectin level in ApoE-/-mice with RNAi-mediated adiponectin gene inhibition.

Objective To investgate the effects of exenatide on islet β-cell function, insulin sensitivity and glucose-lipid metabolism in insulin resistant rats induced by high-fat-chow. Methods High fat-fed rats were treated with exenatide for 6 weeks. The insulin sensitivity, islet β-cell function and glucose lipid metabolism in awake rats were evaluated by intravenous glucose tolerance test (IVGTT), insulin tolerance test (ITT) and hyperinsulinemic-euglycemic clamp technique combined with 3-[3H] glucose as a tracer. In addition, plasma adiponectin level was measured by ELISA. Results Lee′s index and levels of plasma free fatty acids (FFA), triglyceride and total cholesterol were significantly reduced in high fat-fed rats after exenatide treatment for 6 weeks (all P＜0.01). In these rats exenatide also improved IVGTT and ITT, and increased the level of insulin secretion, especially when a high dose was given. In addition, plasma adiponectin level was also significantly increased in the group with high dose exenatide (HFH, P＜0.01). During the clamp steady-state, there were significant increases in plasma FFA and insulin and significant decreases in glucose infusion rate (GIR), glucose disposal rate (GRd) in high-fat group (HF) compared to control group (NC, all P＜0.01). The suppressive effect of insulin on hepatic glucose production (HGP) was significantly blunted (only 26%) in HF group. In HFH group, plasma insulin and FFA levels were significantly decreased (both P＜0.01), GIR and GRd were significantly increased (both all P＜0.01), and HGP was suppressed by 72%. Conclusion It is possible that exenatide pretreatment ameliorates high-fat induced insulin resistance by promoting β-cell insulin secretion, elevating adiponectin level, and improving glucose-lipid metabolism.

Objective To investigate the effects of visfatin gene overexpressian on insulin sensitivity and plasma fibroblast growth factor 21 (FGF-21) level in rats. Methods The recombinant visfatin plasmid was constructed and transfected into normal rats. The euglyeemic-hyperinsulinemie clamp experiments were performed to evaluate the change of insulin sensitivity before and after administration of the plasmid, and plasma FGF-21 level was determined by radioimmunoassay. Results Plasma visfatin levels and glucose infusion rates (GIR) were significantly increased [(1.49±0.06 vs 0.99±0.04) and (35.3±1.4 vs 27.6±1.7) mg·kg-1·min-1,respectively, all P<0.01]. Fasting insulin level was significantly decreased [(14.5±3.7 vs 24.4±6.2) mU/L,P<0.05], total cholesterol and high-density lipoprotein cholesterol were significantly decreased [(1.31±0.10 vs1.76±0.22) mmol/L and (0.59±0.04 vs 0.95±0.15) mmol/L, respectively, all P<0.05], and plasma FGF-21 level was also decreased [(2.25±0.19 vs 2.59±0.23)μg/L, P<0.05] after plasmid being injected 3 days compared with that before injection, but there were no significant differences in fasting glucose and adiponectin levels before and after administration. Conclusion The transfection of visfatin plasmid increases plasma visfatin level, decreases FGF-21 levels and improves insulin sensitivity in normal rats.

Objective A multicenter, randomized, controlled and open-labled clinical trial was performed to compare the efficacy and safety of recombinant human insulin injection ( Yousilin R) and treated with Yousilin R versus Novolin R for 12 weeks respectively. Results Compared with baseline,the levels of glycosylated hemoglobin A1c ( HbA1c ) at the end of 12 weeks treatment decreased from 10. 77% to 7. 72% ( P ＜0. 05 ) in Yousilin R group and from 10. 33% to 7. 62% ( P ＜0. 05 ) in Novolin R group,2-hour postprandial plasma glucose ( 2hPG ) decreased from 15.49 mmol/L to 9. 72 mmol/L ( P ＜ 0. 05 ) in Yousilin R group and from 15.33 mmol/L to 10. 07 mmol/L( P ＜ 0. 05 ) in Novolin R group, and fasting plasma glucose (FPG) decreased from 10. 90 mmol/L to 7. 31 mmol/L( P ＜0. 05 ) in Yousilin R group and from 10. 22 mmol/L to 7.21 mmol/L (P ＜0. 05) in Novolin R group. The changes of HbA1c, 2hPG and FPG from baseline to endpoint in Yousilin R group was similar to those in Novolin R group ( P ＞ 0. 05 ).Furthermore, hypoglycemic events(26. 42% vs 30. 48% ), other adverse events( 13.21%vs 16. 19% ) ,and serious adverse events( 1.89%vs 1.90% )were comparable between Yousilin R and Novolin R groups(P ＞0. 05 ). Conclusions Yousilin R has similar efficacy, safety and compliance profiles to Novolin R group in the treatment of diabetic patients.