Objective To explore the effects of high glucose on glucose transport activity, and phosphorylationandexpressionofinsulinsignalingproteins in primary cultured rat adipocytes. Methods Isolated rat adipocytes were cultured at different glucose concentrations (5, 10, 15, 25 mmol/L) for 24 h. Then the glucose uptake, the phosphorylations of insulin receptor (IR), insulin receptor substrate (IRS) 1 and 2 and protein kinase B (PKB) as well as the protein expressions of IRS1, IRS2, p85 subunit of phosphatitylinositol 3 kinase (p85) and PKB were measured. Results These adipocytes treated with different high glucose showed the impairment of the basal and insulin induced increase in glucose uptake and significant decrease of IR, IRS1 and PKB phosphorylations as well as IRS1 protein expression, but up regulation of IRS2 protein expression. p85 and PKB contents and IRS2 phosphorylation were unaffected. Conclusion The exposure to high glucose inhibits glucose uptake and induces insulin resistance in adipocyte. The mechanism may be involved in affecting the multiple step phosphorylations and the expressions of insulin signaling proteins.

Objective To investigate the expression of forkhead box C2 (FOXC2),Vimentin and E-cadherin protein in colorectal adenocarcinoma and the relationship of FOXC2,Vimentin and E-cadherin with the clinicopathological parameters,and the role of epithelial-mesenchymal transition (EMT) in colorec tal adenocarcinoma and the correlation between FOXC2 and EMT.Methods The expressions of FOXC2,Vimentin and E-cadherin in 102 cases of colorectal adenocarcinoma tissues and 30 cases of adjacent noncancerous tissues were detected by immunohistochemical method,and the correlation between FOXC2 and EMT and the clinicopathological parameters of colorectal adenocarcinoma were analyzed.Results The positive rates of FOXC2,Vimentin and E-cadherin in colorectal adenocarcinoma tissues were 53.9％,40.2％ and 26.5％,respectively.The positive rates of FOXC2,Vimentin and E-cadherin in adjacent noncancerous tissues were 6.7％,0 and 63.3％.Compared to paracancerous tissue,the expression of FOXC2 and Vimentin in colorectal adenocarcinoma was significantly increased,while the expression of E-cadherin was significantly decreased.The positive rates of FOXC2 and Vimentin in lymph node metastasis group were 79.1％ and 67.4％,respectively,which were significantly higher than those without lymph node metastasis (35.6％,P ＜0.01;20.3％,P ＜0.01).The positive rate of E-cadherin in lymph node metastasis group was 16.3％,which was significantly lower than that without lymph node metastasis (33.9％,P ＜ 0.01).The positive rates of FOXC2 and Vimentin in T1 +T2 phase were 41.7％ and 25.0％,respectively,which were significantly lower than those in T3 + T4 stage (83.3％,P ＜0.01;76.7％,P ＜0.01).The positive rate of Ecadherin in T1 + T2 stage group was 33.3％,which was significantly higher than that in T3 + T4 stage (10.0％,P ＜ 0.01).There was a positive correlation between FOXC2 and Vimentin in colorectal adenocarcinoma (P ＜0.01),and negatively correlated with E-cadherin expression (P ＜ 0.01).Conclusions EMT may promote the development and metastasis of colorectal adenocarcinoma,FOXC2 may be involved in colorectal cancer EMT and through the EMT to promote the malignant process of colorectal adenocarcinoma.

With the increasingly tense doctor-patient relationship,the practice teaching of laboratory medicine has obviously been affected.For example,the practice teachings systems do not adapt to the updated situations,and practice teaching has been simplified and communication training ignored.In order to deal with these problems and ensure the goals of practice teaching,various measures have been taken in training hospitals.Firstly,the practice system has been further improved and implemented effectively by strengthening mobilization and adopting qualification licensing before practice and interaction practice between teachers and students and regular communication between school and training hospital during practice and strict assessment after practice.Secondly,medical ethics educations and laboratory biological safety have been strengthened.Thirdly,the modem automation and classic morphology should be integrated.Finally,the ability of communication between medical laboratory and doctor and patients should be cultivated,and so on.These measures are to ensure the effect of the practice teaching and cultivate excellent students.

Objective To investigate the effect of collaborative care model on diseases attitude and self-efficacy of patients with chronic hepatitis B. Methods Ninety-six cases of patients with chronic hepatitis B were selected. Forty-seven cases who were hospitalized from June 2015 to December 2015 were seemed as the control group, while 49 cases who were hospitalized from January 2016 to June 2016 were seemed as the collaboration group. Patients in control group were accepted routine care measures for chronic hepatitis B. Patients in collaboration group were accepted collaboration care measure on the basis of routine care, including patient assessment and collaboration care program development, health knowledge for patients and their families guiding and basic skills training, and psychological guidance intervention. Respectively, at admitting to hospital and after intervention 4 weeks, the diseases attitude of patients with chronic hepatitis B diseases, self-care ability and self-efficacy were assessed. Results There were no significant differences in attitude score, self-care ability score, self-efficacy score before intervention between two groups (P>0.05). They were improved after intervention compared with before intervention, the difference was statistically significant (t=3.197-25.376, P<0.01 or 0.05). The attitude in the face, avoid and give up score respectively in collaborative nursing group after intervention were (28.2±5.3), (9.8±4.2), (5.1±1.7) points, and (23.4±4.1), (14.1±3.8), (8.2±1.9) points in control group, the difference was statistically significant (t = 4.393, 4.220, 9.285, P < 0.01). The health knowledge of self-care ability, self-care skill, since the sense of responsibility, self-concept scale in collaborative nursing group after intervention were (48.2±3.4), (39.5±4.0), (33.1±5.5), (29.1±3.7) points, and (39.4±4.2), (30.2± 3.5), (24.7±4.8), (25.2±3.5) points in control group, the difference was statistically significant (t=5.137-11.286, P<0.01). The self-efficacy in each entry score and total score in collaborative nursing group were (3.4 ± 0.7), (31.5 ± 4.6) points and (2.8 ± 0.4), (20.7 ± 5.1) points in control group, the difference were statistically significant (t=5.288, 14.579, P<0.01). Conclusions Collaborative care model could help chronic hepatitis B patients to establish correct disease attitude, improve self-care ability and enhance self-efficacy.

Clinical data and radiological findings of 78 patients with distal radial fractures,who underwent plain X-ray film and muhislice CT (MSCT) examinations,were retrospectively analyzed.Twenty nine associated carpal bone factures were detected on X-ray film in 21 cases;while 47 associated carpal bone fractures were detected on MSCT in 29 cases (P ＜ 0.05).The missed diagnosis rate of X-ray was 38％.Results indicate that MSCT can significantly improve the detect rate,which should be recommended for diagnosis of associated carpal bone fractures in distal radial fractures.

OBJECTIVE:To explore the characteristics and regularities of cardiac damage induced by metranidazole,and pro-vide reference for clinical safe application. METHODS:In retrospective study,58 cases of cardiac damage caused by metranidazole in Henan ADR Monitoring Center for Drug from Jan. 2010 to Dec. 2015 were analyzed statistically. RESULTS:In 58 cases of cardiac damage induced by metranidazole,25 cases were male,33 were female,the ratio of male to female was 0.76∶1,the patients with ADR/ADE aged 15-64 years (74.14%),most were intravenous administration (79.31%) and happened within 30 min (70.69%), cardiac damage mainly manifested as palpitation,severe cases can cause tachycardia and arrhythmia,the ADR improved or cured af-ter withdrawal or symptomatic treatment. CONCLUSIONS:Clinic should strengthen observation of ADR/ADE caused by metranida-zole,especially the monitoring of cardiac toxicity reactions;pharmaceutical manufacturers should improve the drug instructions to in-sure the safety of clinical medication.

Objectives To investigate the clinical significance of degree Ⅲ meconium-stained amniotic fluid in term pregnancy.Methods Data of 857 full-term gravidas underwent cesarean section for suspected fetal distress in Peking University First Hospital from October 1,2012 to September 30,2014 were retrospectively analyzed.All patients were divided into three groups according to the diagnosis of suspected fetal distress:meconium-stained amniotic fluid group (Group 1,n=172),fetal heart abnormality group (Group 2,n=623) and meconium-stained amniotic fluid in combination with fetal heart abnormality group (Group 3,n=62).General information and fetal prognosis of the three groups were analyzed.Factors that might affect the prognosis of newborns were analyzed between the infants with or without acidosis,asphyxia or aspiration pneumonia.Analysis of variance,independent-samples t test,Chi-square test and rank-sum test were used as statistical methods.Results There were no significant differences in maternal age,gestational age at delivery,parity,nuchal cord loop(s),pH value of umbilical arterial blood and gender of newborns among the three groups (all P＞0.05).The neonatal Apgar score,neonatal asphyxia rate and rate of admitting into pediatric ward within 24 hours after birth in Group 1 were similar to those of Group 2 and 3 [1 min Apgar score:9.9±0.7 vs 9.8±0.7 and 9.8±0.7,F=0.322;5 min Apgar score:10.0±0.3 vs 10.0±0.2 and 10.0±0.0,F=0.517;neonatal asphyxia rate:1.7％ (3/172) vs 2.1％ (13/623) and 1.6％ (1/62),x2=0.129;rate of admitting into pediatric ward:16.3％ (28/172) vs 14.3％ (89/623) and 11.3％ (7/62),x2-0.978] (all P＞0.05).The incidence of neonatal aspiration pneumonia in Group 1 was higher than that of Group 2 and 3 [4.7％ (8/172) vs 3.2％ (2/62) and 1.0％ (6/623)],but the differences had no statistical significance (F=10.680,P=0.050).Conclusions Both degree Ⅲ meconium-stained amniotic fluid and abnormal fetal heart rate have the same indicating significance and should be treated actively to lower the risk of poor prognosis of the newborns.

Objective To explore the preventive effect and mechanism of pioglitazone on nonalcoholic fatty liver disease in rats.Methods Thirty six male Sprague-Dawley ( SD) rats were randomly divided into normal control group , high-fat diet group , and pioglitazone intervention group , with 12 rats in each group .Normal control group fed with standard diet for eight weeks , and the rest two groups fed with high fat diet .Pioglitazone intervention group fed with pioglitazone in the four to eight weeks , the rest two groups in the same period fed with distilled water .Fasting serum alanine aminotransferase , aspartate aminotransferase , total cholesterol , triglyc-erides, fasting glucose , and fasting blood insulin levels were determined .The fasting insulin resistance index was calculated .Routine histological features of hepatic section were observed by hematoxylin eosin (HE) staining.The shape change of Kupffer cells in the liv-er was detected .The levels of tumor necrosis factor ( TNF)-αand nitric oxide ( NO) secreted by Kupffer cells were measured .Results The fasting insulin resistance index , triglycerides , and total cholesterol in rats of high-fat diet group were significantly higher than in normal control group ( P <0.05 ) .Histopathological examination showed hepatocellular macrove sicular steatosis , lobular inflammatory cell infiltration, and inflammatory cell infiltration .Hepatic Kupffer cell morphology change , its produced TNF, NO and liver tissue pa-thology changes were positively correlated ( P <0.05 ) .The fasting insulin resistance index , triglycerides , total cholesterol was signifi-cantly lower in rats of pioglitazone intervention group than the high-fat diet group ( P <0.05 ) .The liver tissue structure was obviously improved pioglitazone intervention group rats , morphology and function of liver Kupffer cells were normal .Conclusions Pioglitazone can prevent the nonalcoholic fatty liver disease induced by high fat diet .The mechanism may be related to improve insulin resistance , reduce blood fat , and regulate function of Kupffer cells .

Objective Study the effects of early overfeeding in the adult offspring of mother with severely hyperglycaemia in pregnancy to islet development and insulin resistance. Methods Thirty healthy female Wistar rats were mated with 10 male Wistar rats and the morning on which sperm were found in three different visual fields of the vaginal smear was designated pregnancy day 1. The pregnant rats were intraperitoneally administered with Streptozotocin (STZ, 50 mg/L) on 5th day of pregnancy, and blood glucose exceeded 20 mmol/L to induce severely gestational diabetes mellitus (SDM) model. The pregnant Wistar rats were assigned to two experimental groups: SDM (n = 16) and control (n = 8). Litter size reduction in the lactation period induced early postnatal overfeeding model. Offspring were divided into three groups according to the level of blood glucose in pregnancy and feeding patterns in lactation: ( 1 ) control group (CG):euglycemia in pregnancy, eight pups in lactation;(2) severely gestational diabetes mellitusnormal feeding (SDM-N):severely gestational diabetes mellitus, eight pups in lactation; (3) severely gestational diabetes mellitus-overfeeding (SDM-O): severely gestational diabetes mellitus, four pups lactation. At the end of the lactation period, all pups were fed standard laboratory chow adlibitum until the date of the experiments. Offspring body weight was measured weekly after ablactation. Serum insulin was measured by enzyme-linked immunosorbent assay (ELISA) and pancreatic islet morphology was analyzed by immunohistochemistry (IHC) in all three groups at 26 weeks of age. Results (1) Blood glucose of pregnant Wistar rats: SDM (28.3 ±5.1 ) mmol/L was statistically higher than control (6.3 ± 1.4) mmol/L ( P ＜ 0.05 ). (2) Growth rates of body weight in 3 - 7 weeks and 3 - 9 weeks: SDM-N: (4. 6 ± 1.3) % and (6.8±2.5)%, SDM-O:(3.2±0.7)% and(4.6±1.2)%,CG:(2.9 ±0.6)% and(4.1 ±0.8)%.The growth rates of body weight in SDM-N and SDM-O were both significantly higher than those in CG ( P ＜0.05 ). (3) Body weight at 26 weeks: CG: (486 ± 132) g, SDM-N: ( 387 ± 115 ) g, SDM-O: ( 382 ± 122) g.There was no statistical difference among the three groups (P ＞0.05). (4) Fasting plasma glucose ( FPG),fasting insulin (FINS), homeostasis model of insulin resistance (HOMA-IR) and insulin sensitivity index (ISI): at 26 weeks, the SDM-offspring has nomal FPG, but more insulin was needed to keep it normal. The insulin level of SDM-O[ ( 12.6 ± 3.3) mU/L ] was statistically higher than those of SDM-N [ ( 10.9 ± 3.3 )mU/L] and CG [ ( 8.6 ± 0.8 ) mU/L ] ( P ＜ 0.05 ). The ISI of SDM-O ( 0.020 ± 0.006 ) was significantly smaller than its HOMA-IR(2.40 ±0.62,P ＜0.05). (5)The morphological change of pancreatic islet: The islets of CG and SDM-N were round or ellipse and have clear boundary between endocrine and exocrine parts and the β cells distributed equally. However, SDM-O islets were not of uniform size and most of islets were hyperplasia and hypertrophy. (6) Relative β cell area of pancreas, β-cell area and islet size: SDM-O:(1.81 ±0.31)%, (57.1 ±3.2)% and(39 067 ±3308)μm2; SDM-N:(1.34 ±0.43)%,(60.9 ±0.6)% and ( 30 570 ± 4824 ) μm2; CG: ( 1.11 ± 0.26 )%, ( 63.7 ± 2.7 )% and ( 26 443 ± 4431 ) μm2.SDM-O has significantly increasing β-cell mass, hypertrophic islet size and slightly decreasing β-cell percentage compared with other two groups (P ＜ 0.05 ). Conclusions The exposure of severely hyperglycemia in pregnancy induces low weight infant and postnatal catch-up growth leading to the possibility of insulin resislance (IR) in adult and early postnatal overfeeding will accelerate such course. Islet morphology of SDM-N has no significant change, indicating that maternal diabetes mainly affected β-cell function but not islet morphological features. SDM overfeeding results in early impairment of islet morphology and function, indicating that the compensation ability of islets has already been impaired and the risk of further development of impaired glucose tolerance (IGT) and diabetes. In conclusion, the nutritonal environment in early life ( duration of pregnancy and lactation) participate in the metabolic programming in adulthood.

Objective To investigate the relationship between insulin resistance index (HOMA-IR) and the clinical pathology fea-tures in chronic hepatitis B(CHB) patients. Methods ALT and hepatitis B virus loading level and HOMA-IR were measured in 80 CHB pa-tients. Correlation analysis was performed with pathological features of liver tissue. Result Insulin resistance(IR) was much more obvious in patients with severer degree of liver inflammation and fibrosis . HOMA-IR and the insulin level of CHB patients in G3 grade(15.24±7.41,3.51 ± 1.91) and S3 stage (16.65±6. 46,3.79 ± 1.50) were higher than those in G2 grade (10.33 ± 6.28,2.25 ± 1.39) and S2 stage(9.06 ± 4.61,2.02 ± 1.11). The HOMA-IR was positive correlated with the level of age and ALT. Conclusion The development of IR in CHB patients was correlated with age and the degree of liver inflammation and fibrosis.