There is a close relationship between visceral adipose tissue and metabolic syndrome. It is necessary to enhance the researches on the inaccordance between the adipocytes of various depots and to elucidate the distinct differences between visceral and subcutaneous adipocytes in terms of their receptors, adipokines and activity of enzymes.

Objective To investigate the effect of solute cartier organic anion transporter family, member 1B1 (SLCOIBI) gene variants on the response to therapy with repaglinide in type 2 diabetes. Methods 100 newly-diagnosed type 2 diabetic patients were treated with repaglinide during a course of 48 weeks. Anthropometrie parameters and indices related to glucose metabolism were measured periodically. Genotypes of SLCO1B1 D130N and V174A were detected by PCR-restriction fragment length polymorphism (RFLP) and sequencing respectively. Results Eighty-nine patients accomplished the 48-week follow-up visits. D130N variant in SLCO1B1 gene was associated with repaglinide treatment, DD genotype had better HbA1C lowering effect than N allele carrier [△HbA1C: (-2.29±0.23) % vs (-1.49±0.21)%, P<0.05]. No association was detected between D130N and the other effects of repaglinide on glucose metabolism related phenotypes. Conclusion D130N variant in SLCO1B1 gene is associated with the response to repaglinide treatment in patients with type 2 diabetes. DD homozygotes had a better effect than N allele carriers.

Objective To explore the effects and mechanisms of hepatitis B virus-X protein (HBx) on invasion and migration of hepatocellular carcinoma (HCC) cells.Methods The retrospective cohort study was conducted.The clinicopathological data of 30 patients with liver tumor (20 with HCC and 10 with benign tumor of liver) who were admitted to the Affiliated Hospital of Xuzhou Medical College between July 2014 and July 2015 were collected.HCC tissues of 20 patients with HCC (with history of HBV infection) were collected by surgical resection and peritumoral normal tissues (outside of tumor capsule) of 10 patients with benign tumor of liver (without history of HBV infection) were collected.The expressions of epidermal growth factor receptor 3 (ErbB3)in HCC tissues and peritumoral normal tissues were detected by immunohistochemistry (IHC).The relative expressions of ErbB3 and HBx in HCC tissues and peritumoral normal tissues were detected by Western blot,and relative expressions of ErbB3 in HepG2 of which green fluorescent protein (GFP) and GFP-HBx were respectively transfected were detected.The relative expressions of ErbB3 mRNA in HepG2 transfected by GFP and GFP-HBx were detected by real-time polymerase chain reaction (RT-PCR).The migration and invasion of HepG2 were respectively detected by Transwell assay with and without matrix.The measurement data with normal distribution were represented as $± s.The comparisons between groups were evaluated with the independent-sample t test.Correlation analysis was done by the Pearson test.Results (1) The expressions of ErbB3 were detected by IHC:relative value of mean optical density (MOD) of ErbB3 in HCC tissues of 20 patients with HCC and peritumoral normal tissues of 10 patients with benign tumor of liver were 2.54± 1.33 and O.99±0.29,respectively,with a statistically significant difference (t =6.542,P ＜ 0.05).(2) The relative expressions of ErbB3 and HBx were detected by Western blot:relative expressions of ErbB3 and HBx were respectively 0.79±0.13,1.10±0.28 in HCC tissues of 10 patients with HCC and 1.07±0.17,0 in peritumoral normal tissues of 10 patients with benign tumor of liver,with statistically significant differences (t =3.229,19.486,P＜0.05).The results of Pearson test showed that there was a positive correlation of expression between ErbB3 and HBx in HCC tissues (r=O.637,P＜ 0.05).(3) The relative expressions and transcriptional levels of ErbB3 were detected by Western blot and RT-PCR:relative expressions of ErbB3 in HepG2 of which GFP and GFP-HBx were respectively transfected were O.75±0.11 and 1.10±0.10,respectively,with a statistically significant difference (t=4.291,P＜0.05).The relative expressions of ErbB3 mRNA in HepG2 of which GFP and GFP-HBx were respectively transfected were O.38±0.03 and O.94±0.07,respectively,with a statistically significant difference (t=11.703,P＜O.05).(4) The effects of ErbB3 on migration and invasion of HepG2:numbers of transmenbrane cell in HepG2 of which His and His-ErbB3 were respectively transfected by Transwell assay with matrix were respectively 271± 18 and 463± 31,respectively,with a statistically significant difference (t =8.202,P＜0.05).Numbers of transmenbrane cell in HepG2 of which His and His-ErbB3 were respectively transfected by Transwell assay without matrix were respectively 315±38 and 549±34,respectively,with a statistically significant difference (t =8.310,P＜0.05).Conclusion HBx protein can promote the invasion and migration of hepatocellular carcinoma cells through up-regulating expressions of ErbB3 protein.

Objective: The study was designed to evaluate the changes and significance of circulating CD4~+CD25~+ and CD8~+CD28~- regulatory T cells (Tregs) in patients with multiple myeloma (MM).Methods:CD4~+CD25~+ and CD8~+CD28~-Tregs in peripheral blood of 38 patients with MM and of 20 healthy doners were measured by flow cytometry.Serum albumin and β_2-MG in patients with MM were measured using bromocresol green method,transmission turbidimetry respectively.Results:Compared to those of the controls,the proportions of CD4~+CD25~(+/high),CD4~+CD25~(high) CD127~(low) and CD8~+CD28~-Treg cells in newly diagnosed MM patients were elevated.Furthermore,the proportions of CD4~+CD25~(high) and CD4~+CD25~(high)CD127~(low) Tregs in each clinical stage were elevated when compared to those of the controls.The number of the Tregs were increasing with clinical stages and were significantly higher in stage Ⅲ MM than in stageⅠ MM;In stageⅡand Ⅲ MM,there were also elevated proportions of CD8~+CD28~- Tregs,increasing with clinical stages.However,there were no differences when compared between stage Ⅰ MM and the controls;Both the proportions of CD4~+CD25~(+/high) and CD4~+CD25~(high)CD127~(low) Tregs in active MM were not different from stable MM,although all of them were higher than those of controls.The proportion of CD8~+CD28~- Tregs was higher in active MM than in stable MM and controls,but there were no differences when compared between active and stable MM.The proportions of both CD4~+CD25~(high) Tregs and CD4~+CD25~(high)CD127~(low)Tregs had negative correlation with the levels of serum albumin.Conclusion:MM patients have elevated levels of circulating CD4~+CD25~+ and CD8~+CD28~-Tregs,which may be an important mechanism of MM immune evasion,and may be associated with clinical stages,disease progression and prognosis of MM to some extent.

OBJECTIVE: To evaluate the effect of the vestibular diagnosis and treatment system (SRM-IV ) in diagnosis and treatment of patients with benign paroxysmal positional vertigo (BPPV). METHOD: Patients who were diagnosed as BPPV by SRM-TV in the clinic of our hospital from November 2013 to October 2014 were retrospectively analyzed in this study. RESULT: Among 425 suspected cases, 230 BPPV-positive patients were diagnosed including 131 cases of posterior SC (57.0%), 95 cases of horizontal SC (41.3%) and 4 cases of more than two SC (1.7%). The cure rate by SRM-V was 94.6% and the effective rate was 100.0%. The relapsed occurred in 10 patients (4.8%), which contained 4 men and 6 women. CONCLUSION SRM-V can realize 360° reasonable repositioning procedure while Canalish reposition procedure cannot. SRM-V can improve both the corrective rate of diagnosis and the cure rate, especially for the patients who suffered from complex BPPV.
Benign Paroxysmal Positional Vertigo ; diagnosis ; therapy ; Female ; Humans ; Male ; Patient Positioning ; Retrospective Studies ; Vestibule, Labyrinth ; physiopathology

Objective:To establish a comprehensive and effective scoring model based on ultrasonic characteristics for predicting the restenosis risk after superficial femoral artery stenting, in order to assess the possibility of in-stent restenosis and to provide guidance for the selection of therapeutic strategies.Methods:A retrospective review of a database of 328 patients (381 limbs) undergoing superficial femoral artery stents in Xuanwu Hospital, Capital Medical University from January 2016 to January 2018 was made as a modeling group.In the modeling cohort, the multivariate logistic regression analysis was performed to screen independent risk factors for in-stent restenosis. A predictive scoring model of restenosis risk was established with weighted score of independent risk factors according to the odd ratio values. Based on the best cut-off value of the receiver operating characteristic (ROC) curves, the scoring table was divided into low-risk and high-risk groups of restenosis.Results:Multivariate logistic regression analysis showed that 8 factors were included in the score system to establish the scoring model of in-stent restenosis risk prediction including calcified plaque, peak systolic velocity of popliteal artery<40 cm/s, runoff scores≥4, ankle-brachial index<0.5, female (1 point each); complicated stroke, complicated chronic renal disease, total lesion length 15.0-24.9 cm (2 points each); total lesion length≥25.0 cm (3 points), a total of 12 points in the model. The validation indicated that the scoring system had good predictive value(AUC=0.775, 95% CI=0.727-0.824, P<0.001) and goodness of fit (Hosmer-Lemeshow χ 2=4.921, P=0.766). The agreement with digital subtraction angiography(DSA) was good (Kappa value=0.609). The scoring system was further divided into the low-risk restenosis (0-5 points) and high-risk restenosis (6-12 points) according to the best cut-off value of 5.5, with a sensitivity of 68.1%, a specificity of 74.6%, and the accuracy of 72.7%. Conclusions:The superficial femoral artery in-stent restenosis risk predicting score model based on ultrasonic characteristics may accurately predict the restenosis preoperatively. It provides a theoretical basis for the precise surgical plans.

This article was aimed to study the chemical constituents of the petroleum ether fraction of Liparis nervosa.Chemicalcompoundswereisolatedandpurifiedthroughvariouschromatographytechniques.The accurate structures of chemical compounds were confirmed with spectral data and literatures. The results showed that7chemicalconstituentswereisolatedfromthepetroleumetherfractionofLiparis nervosa,whichwere moscatin (1), batatasin Ⅲ (2), bergapten (3), isoimpinellin (4), xanthotoxin (5), imperatorin (6) and β-sitosterol (7). It was concluded that chemical constituents 3-7 were isolated from this genus for the first time. And chemical constituents 1-7 were isolated from this plant for the first time.

Leukemia is a group of hematologic malignancie. Ferroptosis is a novel of cell death caused by iron-dependent lipid peroxidation accumulation, which participates in the occurrence and development of leukemia. Activation of different regulatory sites in the ferroptosis pathway can promote the death of leukemia cells. Therefore, it can provide a new direction for the treatment of leukemia by inducing ferroptosis of cells.

Objective To investigate the influence of anterior cerebral artery (ACA) leptomeningealanastomoseson the hemodynamic changes of extracranial intemal carotid artery (ICA) in patients with severe stenosis and chronic occlusion of middle cerebral artery (MCA) disease.Methods One hundred and eighty six cases with severe stenosis and chronic occlusion of MCA diagnosed by transcranial color-coded sonography (TCCS) and confirmed by digital subtraction angiography (DSA) were consecutively enrolled during January 2015 to December 2015.All cases were divided into two groups,including 88 cases of severe stenosis and 98 cases with chronic occlusion.According to DSA results,there were 72 cases with leptomeningeal anastomoses (LMA) and 114 cases without LMA.Transcranial Doppler (TCD) and TCCS were performed to measure and record the peak systolic velocity (PSV),end diastolic velocity (EDV),and resistance index (RI) of bilateral ACA,color Doppler ultrasound was used to measure and record PSV,EDV and RI of bilateral ICA.The ipsilateral and contralateralhemodynamic parameters of ICA and ACA were compared betweenthe two groups by means of independent-samples t test and paired-samples t test.The difference ofhemodynamic parameters between patients with LMA and without LMA were also compared.Linear regression was used to analyze the relevance between ipsilateral ICA and ACA parameters.Results (1) The PSV and EDV of ipsilateral ICA in MCA chronic occlusion group were significantly lower than those in MCA severe stenosis group [(71.27±17.84) cm/s vs (78.07± 14.69) cm/s,(27.00±8.38) cm/s vs (32.01 ±7.83) cm/s,0.625±0.056 vs 0.591 ±0.057;t=2.820,4.243,4.099,all P ＜ 0.01].The PSV and EDV of ipsilateral ICA were significantly lower than the contralateral side in both two group [PSV:(78.07 ±14.69) cm/s vs (85.26 ± 17.42) cm/s,(71.27 ± 17.84) cm/s vs (83.80±22.11) cm/s;EDV:(32.01±7.83) cm/s vs (34.50±7.36) cm/s,(27.00±8.38) cm/s vs (33.22±9.97) cm/s;t=2.847,5.209,2.058,5.626,all P ＜ 0.05].The RI of ipsilateral ICA was higher than that of contralateral side in MCA chronic occlusion group (0.625±0.056 vs 0.601±0.076,t=2.601,P ＜ 0.05),no significantly differenceexist between the RI of two sides were in MCA severe stenosis group (P＞0.05).(2) In two groups,the PSV and EDV of ipsilateral ICA with LMA were significantly higher than those without LMA,while the RI was lower [PSV:(164.19±22.64) cm/s vs (97.56± 19.17) cm/s,(168.95±28.03) cm/s vs (96.72±21.57) cm/s;EDV:(75.68± 12.53) cm/s vs (42.65± 10.03) cm/s,(79.93±13.73) cm/s vs (42.30±11.95) cm/s;RI:0.540±0.036 vs 0.564±0.043,0.526±0.037 vs 0.566±0.051;t=14.604,14.416,13.492,14.444,2.727,4.250,all P ＜ 0.01].The PSV and EDV of ipsilateral ACA with LMA were higher than the contralateral side,and RI was lower [PSV:(164.19± 22.64) cm/s vs (105.19±26.95) cm/s,(168.95±28.03) cm/s vs (97.90±24.18) cm/s;EDV:(75.68± 12.53) cm/s vs (44.10± 13.87) cm/s,(79.93± 13.73) cm/s vs (41.83± 10.88) cm/s;RI:0.540±0.036 vs 0.583±0.050,0.526±0.037 vs 0.572±0.037;t=10.049,15.906,10.313,16.864,4.083,6.145,all P ＜ 0.01].For the parameters of ACA without LMA,there was no difference between two sides (P ＞ 0.05).(3) In MCA with severestenosis group,the parameters of ipsilateral ICA between with and without LMA groupswere not significantly different (P ＞ 0.05).In MCA with chronicocclusion group,the PSV and EDV of ipsilateral ICA without LMA were significantly lower than those with LMA,and RI was higher [(65.93 ± 13.34) cm/s vs (78.68 ± 20.64) cm/s,(23.98±6.30) cm/s vs (31.20±9.08) cm/s,0.638±0.055 vs 0.605±0.053;t=3.713,4.647,2.925,all P＜0.01].(4) In MCA with severestenosis group,no obviously correlation was found in the hemodynamic parameters of ipsilateral ICA and ACA (P ＞ 0.05).In MCA with chronicocclusion group,PSV,EDV of ipsilateral ACA had positive linear correlation with PSV of ipsilateral ICA (r=0.350,0.367,P＜0.01),and had negative linear correlation with RI of ipsilateral ICA (r=-0.550,-0.531,P ＜ 0.01).Conclusions In MCA with severestenosis and chronicocclusinpatients,TCD or TCCS can be used for detecting increased velocity of ACA with LMA.The hemodynamic parameters of ipsilateral ICA could beinfluenced by LMA withdecreased velocity and increased PI when MCA was occluded,but could not be influenced by LMA when MCA was severe stenosis.

Objective: To compare the incidence of adjacent segment degeneration (ASDeg) and clinical outcomes of minimally invasive versus traditional transforaminal lumbar interbody fusion (TLIF) in the treatment of L _4,5 single-segment lumbar spinal stenosis (LSS) and explore the risk factors of ASDeg. Methods: All of 115 patients with LSS who were treated by the same group of doctors from 2009 to 2013, with a minimum follow-up of 5 years. Thirty-eight patients underwent minimally invasive trans-foraminal lumbar interbody fusion (MIS-TLIF) and 77 patients underwent traditional TLIF. Standing radiographs at the preopera-tive period and the final follow-up were assessed. Radiological parameters included lumbar lordosis (LL), fused segment angle (FSA), disc height (DH) and range of motion (ROM). Babu classification was used to identify facet joint violation (FJV) in patients at 5-year follow-up. Clinical outcomes were assessed according to visual analog scale (VAS) score, Japanese Orthopaedic Associa-tion (JOA) score and Oswestry Disability Index (ODI). Student's t-test, Chi-square test, and non-parametric test were used as the main statistical methods. Results: The mean age of MIS-TLIF group was 58.2±8.8 years, and that of TLIF group was 54.7±11.2 years, and there was no significant difference between the two groups. The mean follow-up time was 64.5±3.8 months in the MIS-TLIF group and 63.9±3.3 months in the TLIF group, and there was no significant difference between the two groups. There were 17 cases of degenerative spondylolisthesis in MIS-TLIF group (44.7%) and 35 cases of degenerative spondylolisthesis in TLIF group (45.5%), and there was no significant difference between the two groups. There was no significant difference in DH and ROM of L_3,4, L_4,5, L₅S₁ between the two groups before operation. There was no significant difference in VAS, JOA and ODI scores between the two groups before operation. The VAS, JOA and ODI scores were significantly improved at the last follow-up compared with those before operation. After 5-year follow-up, 56 cases (48.7%) had ASDeg. The incidence of ASDeg was 31.6% in MIS-TLIF group and 57.1% in TLIF group, and there was statistical differences between the two groups (χ²=6.656, P <0.01). Among them, 32 cases only had upper segment ASDeg (6 cases in MIS-TLIF group, 26 cases in TLIF group), 19 cases only had lower segment ASDeg (6 cases in MIS-TLIF group, 13 cases in TLIF group), and 5 cases had both upper and lower ASDeg (5 cases in the TLIF group). The DH of adjacent segments decreased after operation, but the loss of DH in MIS-TLIF group was smaller than that in TLIF group, including L_3,4 segments (-4.9%±6.4% vs-8.7%±7.2%, t=-2.761, P <0.01), L5S1 segment (-4.7%±9.8% vs-10.5%±11.7%, t=-2.623, P <0.01). The ROM of adjacent segments increased in both groups, but the increase of ROM in MIS-TLIF group was smaller than that in TLIF group, including L _3,4 segments (1.1°±1.8° vs 2.3°±2.5°, t=-3.122, P <0.01), L₅S₁ segment (0.9°± 1.9 ° vs 1.8°±1.9 °, t=-2.353, P <0.01). The incidence of FJV was 54.2% in patients with ASDeg in MIS-TLIF group and 47.7% in patients with ASDeg in TLIF group. Chi-square analysis showed that FJV was related to ASDeg in both groups (χ²=3.869, P < 0.05). Conclusion Both of the two surgical methods have good clinical effects on L _4,5 single-segment LSS. The incidence of AS-Deg after MIS-TLIF is lower than that of TLIF. FJV is a risk factor for ASDeg.