Insulin resistance is the important base of the pathogenesis of type 2 diabetes.Physical exercise can improve insulin sensitivity.This article presents an overview of how physical exercise improves insulin resistance and helps the prevention and treatment of diabetes mellitus by analyzing its influence on the level of insulin receptor and post-receptor and adipose cell cytokine.

Objective To explore the levels of serum interleukin-6 and interleukin-18 in newly diagnosed type 2 diabetes mellitus (T2DM) and investigate their roles. Methods The serum interleukin-6 and interleukin-18 levels were detected in 50 newly, diagnosed T2DM patients (T2DM group) and 40 normal subjects (control group). Fasting blood glucose, fasting insulin, blood lipid, body mass index (BMI) and waist/hip ratio (WHR) were measured. HOMA-IR and HOMA-β were calculated. Results The serum interleukin-6 and interleukin-18 levels in T2DM group were significantly higher than those in control group [(2.56 ± 1.09) ng/L vs (1.81±0.80) ng/L, (5.38±0.91) ng/L vs (4.62±0.59)ng/L] (P <0.01).Interleukin-6 level was positively correlated with HbA_1c,while interleukin-18 level was positively correlated with BMI and WHR. Interleukin-6 and interleukin-18 levels were positively correlated. Interleukin-6 and interhukin-18 could predicted the insulin resistance. Conclusion Interleukin-6 and interleukin-18 take part in the development of T2DM, and can be related to the insulin resistance.

Banana streak virus (BSV),a member of genus Badnavirus,is a causal agent of banana streak disease throughout the world.The genetic diversity of BSVs from different regions of banana plantations has previously been investigated,but there are relatively few reports of the genetic characteristic of episomal (non-integrated)BSV genomes isolated from China.Here,the complete genome,a total of 7722bp (GenBank accession number DQ092436),of an isolate of Banana streak virus (BSV) on cultivar Cavendish (BSAcYNV) in Yunnan,China was determined.The genome organises in the typical manner of badnaviruses.The intergenic region of genomic DNA contains a large stem-loop,which may contribute to the ribosome shift into the following open reading frames (ORFs).The coding region of BSAcYNV consists of three overlapping ORFs,ORF 1 with a non-AUG start eodon and ORF2 encoding two small proteins are individually involved in viral movement and ORF3 encodes a polyprotein.Besides the complete genome,a defective genome lacking the whole RNA leader region and a majority of ORF1 and which encompasses 6525bp was also isolated and sequenced from this BSV DNA reservoir in infected banana plants.Sequence analyses showed that BSAcYNV has closest similarity in terms of genome organization and the coding assignments with an BSV isolate from Vientam (BSAcVNV).The corresponding coding regions shared identities of 88％ and ～95％ at nucleotide and amino acid levels,respectively.Phylogenetic analysis also indicated BSAcYNV shared the closest geographical evolutionary relationship to BSAcVNV among sequenced banana streak badnaviruses.

Objective To assess the diagnosis value of epithelial membrane antigen (EMA) immunocytochemistry examination in meningeal carcinomatosis.Methods The routine cerebrospinal fluid cytologic examination and EMA immunocytochemistry examination of 23 cerebrospinal fluid specimens from 14 patients with definitive meningeal carcinomatosis were analyzed,retrospectively.Results The positive rate of routine cerebrospinal fluid cytologic examination and EMA immunocytochemistry examination were 39.13%(9/23)and 86.96%(20/23),respectively. There was a significant difference between two results ( P

Objective To study the clinical features and treatment of horizontal canal benign paroxysmal positional vertigo (HC-BPPV).Methods The clinical features of 27 patients with HC-BPPV and the treatment results with otolith repositioning maneuver of Barbecue rotation were analyzed retrospectively.Results All the patients with HC-BPPV had vertigo attack and this kind of vertigo attack presented with some characters such as brief, positioning, latency and no fatigability. Geotropic nystagmus was seen in 21 patients and apogeotropic nystagmus was seen in 6 patients when head was turned to either side in supine position. After Barbecue rotation, all symptoms disappeared in patients with geotropic nystagmus and did not change in patients with apogeotropic nystagmus.Conclusions The diagnosis of HC-BPPV is based on typical clinical features and test of turning head to either side in supine position. Geotropic nystagmus is associated with canalithiasis and apogeotropic nystagmus is associated with cupulolithiasis, and the therapy of Barbecue rotation is very effective to HC-BPPV patients with geotropic nystagmus.

Objective To evaluate the clinical features and treatment of posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV).Methods To retrospectively analyse the clinical features and therapy results of 120 patients with PC-BPPV from January 2003 to November 2004 in the Chang Zheng Hospital of the Second Military Medical University.Results Vertigo attack of PC-BPPV had such characters as brief period,positioning,latency and fatigability.Geotropic rotatory nystagmus occurred in 108 patients and apogeotropic rotatory nystagmus in 12 patients in the test of Dix-Hallpike,and the former received the repositioning maneuver therapy of Epley and the later received the therapy of Semont maneuver.The symptoms disappeared completely in 88 patients after a single session and 12 patients after twice、6 patients after triple sessions of Epley repositioning maneuver therapy in the former,no effectiveness in 2 patients;the symptoms remitted in 8 patients after once,2 patients after twice and 1 patient after triple sessions therapy of Semont repositioning maneuver in the later,no change in 1 patient.The total success rate was 97.5%(117/120).Fifteen patients had relapse during follow-up and the recurrence rate was 12.5%(15/120).They also responded to repositioning maneuver therapy.Conclusion The diagnosis of PC-BPPV is based on the typical clinical features and the test of Dix-Hallpike.The repositioning maneuver therapy is safe and effective for PC-BPPV and should be used for all patients when the diagnosis is clearly made.

Objective To discuss the clinical features of pregnant women with hypertrophic cardiomyopathy (HCM).Methods There were 28 patients with HCM who delivered in Renji hospital of Shanghai Jiaotong University from January 2000 to August 2012.Clinical data were analyzed,including diagnosis,cardiac functional grading,gestational weeks of delivery,delivery mode,birth weight,Apgar scores,etc.Results (1) Of all the 28 patients,14 (50％) were diaguosed before pregnancy and others (50％) were diagnosed during pregnancy.(2) Four cases were obstructive HCM (14％),3 with cardiac function grade Ⅰ and 1 with grade Ⅱ.Twenty four cases were non-obstructive HCM (86％),14 with cardiac function grade Ⅰ,9 with grade Ⅱ and 1 with grade Ⅳ.(3) Of all the 28 patients,4 had family history,18 (64％) had clinical symptoms or signs which occurred in 8-32 gestational weeks.Twenty-three cases had abnormal ECG (82％).Among them 21 had non-obstructive HCM (88％),with average interventricular septal thickness of(22 ± 3) mm.The other 2 patients had obstructive HCM,with average interventricular septal thickness of (23 ± 4) mm.7 patients (7/28,25 ％) had mild-to-moderate pulmonary hypertension [6 with non-obstructive HCM (6/24,25％)],and 10 patients had abnormal myocardial enzyme spectrum or troponin levels [9 with non-obstructive HCM (9/24,38％)].(4) Among all the patients,only one had vaginal delivery and others received cesarean section.Twenty-two patients had term pregnancies and 6 had preterm birth.The average gestational weeks of delivery in non-obstructive HCM and obstructive HCM were (36.5 ± 2.5) and (38.5 ± 0.4) weeks,respectively.The average birth weight of neonates were (2684 ± 563) and (3164 ± 321) g,and Apgar scores were 9.9 and 10 (10 minutes) respectively.Patients transferred to NICU after delivery were 8 and 0.There was 1 maternal death(with nonobstructive HCM whose ejection fraction was only 26％) and no perinatal death.Conclusions More attention should be paid to the clinical signs and abnormal ECG.HCM could be definitely diagnosed by timely echocardiography.Patients with hypertrophic cardiomyopathy were mainly non-obstructive HCM,with cardiac function grade Ⅰ and Ⅱ.Monitoring the change of ejection fraction during pregnancy would help.Perinatal outcomes were fine.

OBJECTIVE: The purpose of this study is to assess the effects of aging on air-conducted sound elicited cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential(oVEMP) in normal people. METHOD: Sixty normal subjects were recruited for the vestibular evoked myogenic potential examination. Among them, 20-40 year-old group was setted as the first group, 41-60 year-old group was setted as the second group, > 60-year-old group was setted as the third group. Each group included 20 normal subjects. SPSS 16.0 software was used to analyze the data. RESULT: As the age growing, P1 latency prolonged, N1-P1 amplitude decreased, and amplitude asymmetric ratio increased in cVEMP; N1 latency prolonged, P1-N1 amplitude decreased, and amplitude asymmetric ratio increased in oVEMP. CONCLUSION With the age growing, the time of otolithic organ input pathways prolonged, the function of otolithic organ decreased and the decrease level may be asymeetrical on both sides.
Adult ; Aging ; Eye ; Head ; Hearing ; Humans ; Middle Aged ; Otolithic Membrane ; Vestibular Evoked Myogenic Potentials ; Vestibule, Labyrinth ; Young Adult

Objective To explore the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) with bilateral positive Dix-Hallpike test.Methods This is a retrospective study based on the clinical data of BPPV patients diagnosed in the Dizziness Clinic of Changzheng Hospital from January 2012 to December 2012.Totally 490 patients with vertigo and nystagmus provoked by Dix-Hallpike maneuver were included in the present analysis.Results Among all the patients,55 (11.2％) of them presented with bilateral nystagmus by the provocative test.According to the type of nystagmus provoked by DixHallpike maneuver,the 55 patients can be divided into the following four categories.(1) Bilateral geotropic (n =16) and apogeotropic nystagmus (n =5):all these patients were diagnosed with horizontal canal BPPV and free of vertigo after head side-shaking exercise in supine position and Barbecue maneuver.(2) Bilateral predominant down-beating nystagmus (n =2):patients in this group were diagnosed with anterior canal BPPV,and got recovered after Kim maneuver.(3) Bilateral torsional up-beating geotropic nystagmus (n =20):after a lying-down test,6 of the patients manifested as vertical up-beating nystagmus and 14 patientsremained torsional up-beating nystagmus.The formerwere diagnosed with bilateral posterior canal BPPV,and were cured after bilateral PRM therapy,and the latter were diagnosed with horizontal canal BPPV,who were cured after Barbecue maneuver.(4) Torsional up-beating geotropic nystagmus on one side and down-beating nystagmus on the other side (n =12).The down-beating nystagrnus on the other side disappeared when the patients was firstly seated up with head down in 30 degrees for half an hour before second Dix-Hallpike maneuver.These patients were diagnosed with unilateral posterior canal BPPV and cured by PRM therapy.Conclusions It is common for vertigo patients with bilateral nystagmus induced by Dix-Hallpike test.The diagnoses should be made by the types of nystagmus provoked step by step before maneuver therapy.

BACKGROUND:Kienb?ck disease lacks of suitable animal models, which are similar to the pathological process of avascular necrosis of human lunate bone.
OBJECTIVE:To establish a new animal model of Kienb?ck disease using medical TH adhesive embolism and to explore the rationality of model establishment.
METHODS:A total of 30 healthy adult New Zealand rabbits, male or female, were selected. Using self-control method, the rabbits were randomly assigned to experimental sides and control sides. By dril ing in the center of the lunate bone, 0.2 mL of medical TH glue was injected three times. An equal volume of physiological saline was injected into the center of the lunate bone on the control side. X-ray examination, general observation, Micro-CT measurement of bone, and tissue pathology detection were conducted at 4, 8 and 12 weeks.
RESULTS AND CONCLUSION:Gross specimen, X-ray and histological results showed that ischemic necrosis of the lunate bone on the experimental side was visible at 8 weeks after model induction. The ischemic necrosis of the lunate bone became more typical at 12 weeks. Among the Micro-CT microscopic parameters of trabecular bone, trabecular bone density parameters bone volume fraction and the number of trabecular bone were significantly lower on the experimental side than those on the control side (P<0.05). Spatial parameters of trabecular bone significantly increased. Trabecular separation and structure model index on the experimental side were significantly greater than those on the control side. Results suggested that ischemic necrosis of the lunate bone appeared on the experimental side at 8 weeks after injection of medical TH glue. Rabbit models of ischemic necrosis of the lunate bone can be established at 12 weeks. Thus, alterations, which were similar to ischemic necrosis of human lunate bone, appeared, such as blood transportation damage in the lunate bone, trabecular bone fracture, and empty lacuna, when surrounding tissues were not obviously injured.