The pathogenesis of obesity in children is unclear.Genetic play an important role,including gene mutations,polymorphisms,epigenetics.And the other hand,environment factors such as intrauterine environment,nutrition,physical exercise,and gut microflora also affect the obesity.The genetic and environment factors have interaction,leading to the occurrence of childhood obesity and development.With the advances in molecular biology techniques and large-scale,large sample size of population screening,new obesity-related genes,single nucleotide polymorphisms,the apparent genetic markers will continue to be found,looking forward to the future predict obesity,to choose to guide effective treatment,or even contribute to the development of genetic targeting drugs.

Objective To investigate CT stage of carcinoma of gallbladder and its role in preoperative evaluation of surgical resectability.Methods CT staging with reference to current literature was made retrospectively in 80 cases of carcinoma of gallbladder proved pathologically and imaging studies.Surgical resectability was evaluated in combination with surgical and pathological results on different stages of this disease.Results In this group,there were stage Ⅰin 9 cases,stageⅡ in 18 cases,stage Ⅲin 42 cases and stageⅣ in 11 cases.32 cases were radically resected,among them,9 were stage Ⅰ,18 stage Ⅱ and 5 stage Ⅲ.Palliative resection was done on 31 cases;all were stage Ⅲ.Exploratory surgery were done on 9 cases(6 stage Ⅲ and 3 stage Ⅳ),by they were unresectable.8 cases (CT stage Ⅳ on CT)had no surgery,but treated otherwise.Conclusion CT studies and staging of gallbladder carcinoma are conducive to preoperative evaluation of surgical and choice of appropriate treatment planning.

Maturity-onsetdiabetesoftheyoung(MODY),amonogenicformofdiabetes,hasmorethan8 well-known subtypes:MODY1( hepatocyte nuclear factor - 4A,HNF4A ),MODY2( glucokinase,GCK ),MODY3 (hepatocyte nuclear factor-1A,HNFIA),MODY4(pancreatic and duodenal homeobox,PDX),MODY5(hepatocyte nuclear factor-1B,HNFIB),MODY6(neuronal differentiation 1,NEUR0DI),MODY7(carboxyl ester lipase,CEL) and MODY8( insulin,INS). The molecular pathology,clinical manifestations and treatment of MODYs are different and reviewed.

Bone metastasis occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. Several sequences occur as a result of osseous metastases and resulting bone pain can lead to significant debilitation. Pain associated with osseous metastasis is thought to be distinct from neuropathic or inflammatory pain. Several mechanisms, such as invasion of tumor cells, spinal cord astrogliosis,and sensitization of nervous system, have been postulated to cause pain. Pharmaceutical therapy of bone pain includes nonsteroidal analgesics and opiates. These drags are associated with side effects, and tolerance to these agents necessitates treatment with other modalities. Bisphosphonates act by inhibiting osteoclast-mediated resorption and have been increasingly used in treatment of painful bone metastasis. While external beam radiation therapy remains the mainstay of pain palliation of solitary lesions, bone-seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions. 32p has been used for over 3 decades in the treatment of multiple osseous metastases. The myelosuppression caused by this agent has led to the development of other bone-seeking radiopharmaceuticals, including 89SrCl, and 153Sm-ethylenediaminetetramethylene phosphonic acid (153Sm-EDTMP). 89Sr is a bone-seeking radionuclide, whereas 153Sm-EDTMP is a bone-seeking tetraphosphonate; both have been approved by the Food and Drug Administration for the treatment of painful osseous metastases. While both agents have been shown to have efficacy in the treatment of painful osseous metastases from prostate cancer, they may also have utility in the treatment of painful osseous metastases from breast cancer and perhaps from non-small cell lung cancer. This article illustrates the salient features of these radiopharmaceuticals, including the approved dose, method of administration, and indications for use.

BACKGROUND: The image edge of rabbit femur is identified using self-programmed Matlab program. But owing to the complexity of the model, can we set up a femoral structure model after the solid model of the femur created in UG three-dimensional (3D) software is put into ANSYS software? OBJECTIVE: To explore the method of constructing 3D biomechanical model of rabbit femur.DESIGN: Randomized controlled observation.SETTING: Biomechanics Laboratory of Beijing Institute of Technology.MATERIAL: One 1-year-old female New Zealand white rabbit weighing 2.6 kg. ACTIS 400/225 industry CT scanner (BIR,USA).METHODS: The experiment was performed at the Biomechanics Laboratory of Beijing Institute of Technology from July to transformed into *.bmp format. Photoshop image processing software was applied for some essential processing on the original image, such as contrast control, smoothing and noise attenuation to strengthen the differentiability and analyzability of the image. In addition, the magnetic noose tool was used to outline the contour line of inside and outside boundary, and obtain the inside and outside contour line of every layer of the femur. The rabbit femur was scanned by industry CT starting from the upper extreme of the femur, vertical to femoral ordinate axis line (slice space=I ram). The scanning slice space was adjusted to 2 mm from the 43rd layer below small trochanter to the 53ra layer of middle femur because the shape between these layers was relatively regular. Totally 87 slices of layer images were scanned 9.9 cm in length. The image was put into the computer and processed to get the boundary contour line; the contour line coordinate for modeling was obtained through imported from UG into ANSYS software. A solid model of the femur was produced automatically. Finally, the solid model with cavity was obtained using subtraction option of Boolean in ANSYS.MAIN OUTCOME MEASURES: Establishment of rabbit femoral structure model. connected by the multiple valid points was formed. The 2nd, 3rd, 4th until the 87th layers were read in turn, and the inside and automatically divide the mesh to produce finite element meshes and 42 221 nodes and 27 768 elements were obtained. CONCLUSION: The 3D model of rabbit femur actually simulated the anatomic appearance of the femur. This model lays a foundation for identifying the optimal parameter of vibration that can improve bone mineral density by finite element analysis.

Objective To establish and evaluate a new mouse model of allergic contact dermatitis (ACD)-primary ACD mouse model.Methods To establish classical ACD mouse model,mice were sensitized with 1-fluoro-2,4-dinitrobenzene (DNFB)on day 1 and elicited with DNFB on day 6,and primary ACD mouse model was built by painting Of 10 μL 0.2%DNFB once on the ear.Mice were kilied 24 hours after the elicitation in classical model group and 6 days after the sensitization in primary model group;skin specimens were obtained from the right ear of these mice.Ear swelling after painting was used as clinical index.ELISA and real time RT-PCR were performed to measure the expression of IL-2,IFN-γ and IL-4 in these specimens.Local lymph node assay was carried out and flow cytometry was used to detect the proliferation and activation of T lymphocytes in local lymph nodes.Results Ear swelling respouse was observed 6 days after ear challenge with DNFB in primary ACD,which was the same as the time interval from back elicitation to occurrence of ear inflammation in classical ACD.Kinetics of the inflammatory response to DNFB during primary ACD Wag similar to that during classical ACD.In both models,the ear tissues were mainly infiltrated by mononuclear cells;a significant increase was observed in the tissue levels of IL-2 and INF-γ as well as in the proliferation and activation of T lymphocytes in local lymph nodes;while there were no significant changes in the level of IL-4,compared with the normal control mice.Conclusions Similar to classical ACD,Thl type cell-mediated immune responses were reproduccd in primary ACD mousc model,and each model can take the place of the other in comparative research.

Objective To investigate the different clinical features of metabolic syndrome(MS)in middle-aged and elderly patients.Methods Data were collected from 947 MS patients,for whom the diagnosis was established based on the Chinese criteria.Of them,679 were elderly people and 268 were in middle-age.Laboratory examination and medical history were analyzed.BMI,blood glucose,blood pressure(BP)and lipid profile were measured.Patients were divided into different groups according to age and sex.Results In the elderly group,the age of male and female patients was 81.5?6.5 and 74.5?8.8 years,respectively.BMI of elderly males were higher than that of middle-aged males(27.14?2.51 vs 25.98?2.38).All the elderly patients had higher systolic BP,but lower triglyceride level than that of the middle aged patients.In middle-aged group,female patients had higher high-density lipoprotein.Fasting blood glucose level in all the investigated subjects was correlated with postprandial glucose(for male R2=0.463,P

Objective To analyze the clinical features of aged men with hyperinsulinemia, and to explore its influence factors. Methods 521 aged persons belonging to the high-risk population of diabetes mellitus (DM) were given 75g oral glucose tolerance test (OGTT), and then divided into hyperinsulinemia group and normal insulin group according to the plasma insulin levels. Clinical features, glucose metabolism state, constituent ratio, complicating diseases, ? cell function and insulin resistance were compared between the two groups. Insulin resistance was determined by HOMA-IR, and ? cell function was determined by HOMA-?. The relationship between glycometabolic change and body weight was analyzed in hyperinsulinemia patients for a period of 2-10 years. Results 195 cases were in hyperinsulinemia group, and 326 cases were in normal insulin group. Compared with the latter, the subjects in hyperinsulinemia group showed higher values of BMI, waistline, fasting blood glucose (FBG), postprandial glucose (2hPBG), and systolic and diastolic blood pressure (SBP, DBP)(P

Objective To investigate the approaches and clinical value of intra-abdominal fluid monitoring after laparoscopic splenectomy (LS). Methods We collected the data of 63 cases of LS performed in the West China Hospital from November 2005 to August 2008,and analyzed the level of amylase in intra-abdominal fluid,changes of color,volume,and characteristics of the drainage fluid,as well as the results of germiculture and ultrasonography. Results Among the cases,post-LS complications were detected by intra-abdominal fluid monitoring in 4 cases early after the surgery. In the four cases,2 patients showed hemorrhagic fluid (over 40 ml/h),and then was found having postoperative bleeding in the splenogastric ligament by abdominal exploration in 12 hours. In the other 2 patients,ravidous drainage fluid was detected in 6 days after the operation,and increased levels of amylase (15 189 and 9206 U/L,respectively) was revealed while germiculture was negative; pancreatic fistula (PF) was then diagnosed and somatostatin was administered. Of the 2 patients who developed PF,intra-abdominal drainage was patent in 1,and the drainage tube was withdrawn in 20 days; for the other cases who had non-patent drainage,ultrasonography-guided percutaneous puncture catheter drainage was performed,and the drainage tube was taken out in 2 months. Conclusions LS is safe,reliable,and minimally invasive. Postoperative monitoring of intra-abdominal fluid is valuable for early detection of post-LS complications.

In order to explore the clinical feature, diagnosis and differential diagnosis of adrenal incidentalomas, we reviewed 98 cases of adrenal incidentalomas for which adrenalectomy was performed in our hospital from 1993 to 2002. It was found that the average age of the patients was 48 years old, 16 cases (16 3%) had no specific symptoms, and others were incidentally diagnosed. Of the 98 cases, 18 (18 4%) were malignant lesions, including 8 metastatic cancers, 8 adrenal carcinomas and 4 lymphangioma, and 80 were benign lesions. Twenty one cases were functioning adrenal adenoma. Ultrasound, CT scan, MRI or MIBG were effective methods to detect adrenal incidentalomas.