Objective To observe the changes of leptin levels in newly diagnosed type 1 diabetic patients and the effect of insulin therapy on serum leptin levels,so as to investigate the relationship between insulin and leptin.Methods Twenty-nine type 1 diabetic patients were enrolled from out-patient clinic and ward of our hospital.Twenty healthy people in our hospital were selected as normal controls.All blood samples were obtained after an overnight fasting for 14 hours.Fasting serum levels of glucose,hemoglobinA 1c(HbA 1c),triglycerides,cholesterol,insulin,C-peptide and leptin were analyzed in all subjects.The type 1 diabetic patients received insulin injection subcutaneously,and levels of glucose,insulin,C-peptide and leptin were measured 2 weeks later.Results In newly diagnosed type 1 diabetic patients,leptin levels were lower than those in normal controls (P0.05).It was found by correlation analysis that in control group,serum leptin levels were correlated with sex,BMI and serum insulin levels,while in newly diagnosed type 1 diabetic group,serum leptin levels were related to sex and serum insulin levels.Conclusion Serum leptin levels of patients with newly diagnosed type 1 diabetes are lower than those in control group.It is likely that short-term insulin injection subcutaneously can not affect serum leptin levels.

Objective: To explore a way of getting satisfactory face shape and function with a retrospective study in 70 patients with midface fractures.Methods:70 cases were selected.Fractures were treated with miniplate according to the sites and different operation methods.Results:Occlusions and face profiles were normal.Each operation method had its own advatages and disadvanges.Conclution:The rigid internal fixation is effective for midface fracture and the choice of operation methods should depend on the sites of fractures.

Objective To study the predictive value of islet cell antibody (ICA),64KD protein antibody(64KDAb) and insulin auto-antibody (IAA) in the first-degree relatives of type 1 diabetics. Methods The determination of islet autoantibody distribution in type 1 diabetes patients,first-degree relatives without diabetes and normal individuals was made. Results The results revealed that ICA and 64KDAb positive rate in type I diabetes patients and their first-degree relatives was significantly higher than normal individuals. The positive rate of 64KDAb is higher than that of ICA and IAA. Conclusion These results suggest that 64KDAb's sensitivity is higher than ICA and IAA's,so 64KDAb is more valuable as the marker of predicting type 1 diabetes. The combined determination of ICA, 64KDAb and IAA might improve the value for predicting diabetes.

Objective　To study the predictive value of islet cell antibody (ICA),64KD protein antibody(64KDAb) and insulin auto-antibody (IAA) in the first-degree relatives of type 1 diabetics.Methods　The determination of islet autoantibody distribution in type 1 diabetes patients,first-degree relatives without diabetes and normal individuals was made.Results　The results revealed that ICA and 64KDAb positive rate in type I diabetes patients and their first-degree relatives was significantly higher than normal individuals.The positive rate of 64KDAb is higher than that of ICA and IAA. Conclusion　These results suggest that 64KDAb's sensitivity is higher than ICA and IAA's,so 64KDAb is more valuable as the marker of predicting type 1 diabetes.The combined determination of ICA,64KDAb and IAA might improve the value for predicting diabetes.

ObjectiveTo explore the treatment efficacy and feasibility of large dose of cytidine diphosphate choline (CDPC) in cardiopulmonary cerebral resuscitation.MethodsOne hundred and thirtytwo patients with sudden cardiac arrest successfully treated by the cardiopulmonary cerebral resuscitation were divided into treatment group ( 75 patients) and control group (57 patients) by random number tables.Two groups of patients were given adrenaline resuscitation drugs,reducing the intracranial pressure drugs,hypothermia,hormones and other basic treatment.Control group used CDPC 0.25 g with glucoseinjection 300 ml to do intravenous drip (once a day,21 days as a period of treatment),and treatment group added CDPC to 2.00 g.The patients were treated by basic traditional analeptic.The Glasgow coma scale (GCS) was carried out in two groups in admission to hospital and 3,7,14,21 days after treatment,and the changes of lysophosphatidic acid (LPA) and phosphatidic acid (AP) level were monitored.ResultsThe GCS score was significantly higher in treatment group 7,14,21 days after treatment(P ＜ 0.05 or ＜ 0.01 ),but GCS score had no significant difference before and after treatment in control group(P ＞ 0.05).The level of LPA in treatment group was significantly decreased 14 days after treatment [ (2.98 ± 0.28) μmol/L ] and 21 days after treatment[ (1.85 ± 0.21)μmol/L],and had significant difference compared with that admission to hospital [ (3.75 ± 0.22) μ mol/L ] (P ＜ 0.05 or ＜ 0.01 ).In control group,there was no significant difference before and after treatment (P ＞0.05).The level of AP in treatment group 21 days after treatment was significantly decreased compared with that in control group [ ( 3.45 ± 0.23 ) μ mol/L vs.( 5.20 ± 0.21 ) μ mol/L ](P ＜ 0.01).ConclusionLarge dose of CDPC can improve neurological function of cardiopulmonary cerebral resuscitation,which is a safe,effective and easy way to be popularized.

Two human endometrial carcinoma cell lines, HEC-1-A and RL95-2, were treated with adiponectin,and then changes of cell count, apoptosis and cell cycle arrest were measured. The expression of phospho-AMPK(Thr172) and AMPK was determined by Western Blot. The results showed that adiponectin may exert direct anti-proliferative effects on HEC-1-A and RL95-2 cells by inducing cell cycle arrest and apoptosis, which may be mediated by AMPK pathway.

Objective To investigate the role of activation of Akt/mTOR pathway in denfense against UVB-induced apoptosis in cultured human skin keratinocyte cell line HaCaT. Methods HaCaT cells were irradiated with UVB at different doses for various durations. Western blotting was performed to detect dynamic changes of Akt/mTOR pathway-related signaling molecule, such as phosphorylated-epidermal growth factor receptor (EGFR), -Akt, -4EBP1, etc; apoptosis was estimated by staining with DNA dye Hoechst 33342. To evaluate the role of signaling molecules in defense against UVB-induced apoptosis, HaCaT cells were pretreated before irradiation with EGFR inhibitor (PD153035), PI3K inhibitor (LY294002), mTOR inhibitor (rapamycin) followed by the detection of expressions of signaling molecule and apoptosis. Results UVB could activate Akt/mTOR pathway in a dose- (5 ～ 30 mJ/cm2) and time- (5 ～ 30 min) dependent manner. PD153035,LY 294002 and rapamycin could inhibit UVB-induced activation of the Akt/mTOR pathway. The apoptosis rate in HaCaT cells was upregulated by pretreatment with rapamycin and LY294002. Conclusion The activation of Akt/mTOR signaling pathway could inhibit the UVB-induced apoptosis in cultured HaCaT cells.

Objective To use evidence-based nursing on patients with artificial airway to the practice of stomach tube, and to evaluate the self made guidance for difficult gastric tube placement in patients with artificial airway.Methods Forty patients with artificial airway and were difficult to put the tube, and admitted to Department of Critical Care Medicine of Harrison International Peace Hospital Affiliated to Hebei Medical University from April to December in 2016 were enrolled as observation group. Through the evidence-based nursing strategy, the related literatures at home and abroad were collected to search clinical evidence and formulate and implement the nursing program, the gastric tube was inserted into the stomach tube under the direct vision of the laryngoscope. Thirty-six patients of difficult gastric tube placement with artificial airway straightly under the direct vision of the laryngoscope from August 2015 to March 2016 were retrospectively analyzed as the control group. The success rate of first catheterization, indwelling time, throat edema and bleeding of pharyngeal mucosa were compared between the two groups.Results All patients were enrolled in the final analysis. In the control group, 28 patients were successfully placed once, while 8 failed. Only 1 patient in observation group failed to catheterize, and successful placed after symptomatic treatment, the one-time success rate of catheter was significantly higher than that of control group (97.5% vs. 77.8%), and catheter time was significantly shortened (minutes: 4.8±1.2 vs. 5.1±1.0), the difference was statistically significant (bothP < 0.05). There were 2 patients with laryngeal edema in the control group and 4 patients of pharyngeal mucosal hemorrhage. In the observation group, there was no laryngealedema and laryngeal edema occurred in the patients with laryngoscopy, and only 1 patient had a hemorrhage of pharyngeal mucosa.Conclusion Using self made guiding device can effectively insert the difficult gastric tube in patients with artificial airway, and increase the one-time success rate of intubation, shorten the catheter time, and have a trend in reduce complication as compared with traditional gastric tube placement.

Objective To reseach variation of clinical and imaging in different stages of patients with SARS.Methods The author reviewed imaging findings and the clinical manifestations of 123 cases of SARS.Results Imaging changes (1)Early stage lesions were singular focus and multifocuses.Focuses exihibited multiform and multishape.The lung parenchyma not change evidently.(2)Progressive stage focuses developed rapidly,the extent enlarged,the number of focuses increased rapidly,multiform and multishape in imaging manifestations.(3)Absorb stage focuses evidently shruink,less dense and focal fibrosis.Clinical manifestation (1)Early stage the clinical manifestations were characterized by the onset of fever,associated with systemic and joint aching pains and dry coughs.Leucocyte counts showed normal or lower than normal. (2)Progressive stage these symptoms worsened and saturation degree of blood oxygen declined.20% patients developed ARDS.80% patients recoveried and leaved from hospital.Conclusion Imaging changes in patients with SARS took after the other pneumonia and may be indistinguishable from other conditions that result in airspace disease.But imaging findings offers an important diagnostic clue to SARS,and it is valuable in showing response to therapy and understanding state of an illness.

Objective To explore the effects of dipeptidyl peptidase ( DPP-4 ) inhibitor on proteins expression of Bcl-2 and Bax of islet β-cells through increasing the expression of islet γ amino acid butyric acid ( GABA) . Methods A total of 50 rats of clean grade were studied. Among them, ten rats were randomly selected as normal controls, the remaining forty rats were fed with high-fat diet and then intraperitoneal injection with streptozotocin, the diabetic rats models were then established. Rats were randomly divided into three groups:i. e. diabetic control group, DPP-4 inhibitor group, and antagonist group ( DPP-4 inhibitor and GABA receptor antagonist). Six weeks later, blood glucose, serum insulin, glucagon, and the proteins expression of GABA, Bcl-2, and Bax of islet β-cells were measured. Results ( 1 ) Compared with diabetic control group, serum insulin was increased(P<0.05),bloodglucoseandserumglucagonweredecreasedinDPP-4inhibitorgroup(P<0.05). (2) Compared with DPP-4 inhibitor group, serum insulin was decreased(P<0. 05), blood glucose and serum glucagon were increased(P<0. 05) in antagonist group. (3) Compared with diabetic control group, the expression of GABA was increased(P<0. 05), the expression of Bcl-2 protein was increased (P<0. 05) in pancreatic β-cells in DPP-4 inhibitor group. ( 4 ) Compared with diabetic control group, the expression of GABA in pancreatic β-cells was increased in antagonist group(P<0. 05) . Compared with DPP-4 inhibitor group, the expression of Bax protein in pancreaticβ-cells was increased in antagonist group(P<0. 05) , while the expression of Bcl-2 protein was decreased (P<0. 05). Conclusions DPP-4 inhibitor could increase the secretion of insulin, decrease the secretion of glucagon, up-regulate expression of anti-apoptosis protein Bcl-2, and down-regulate expression of apoptosis protein Bax in pancreatic β-cells through increasing the expression of GABA, inhibiting pancreatic β-cells apoptosis and protecting the damagedβ-cells in type 2 diabetic rats.