Objective To investigate the clinical and imaging characteristics of isolated pontine infarction as well as the influencing factors for early progressive motor deficits (PMD) and short-term prognosis.Methods A total of 86 patients with isolated pontine infarction who admitted in hospital within 24 hours of symptom onset were analyzed retrospectively.The patients were divided into paramedian pontine infarction (PPI) and lacunar pontine infarction (LPI) according to the maximal diameter of the lesions and the locations of infarction.They were divided into either a PMD group or a non-PMD group according to the early status of PMD.They were also divided into a poor outcome group (mRS score ＞ 2) and a good outcome group (mRS score ≤ 2) according to the modified Rankin Scale (mRS) scores at discharge.The clinical and imaging features of the different patient groups were compared.Results The patients' constituent ratios of hyperlipidemia (57.14％ vs.33.33％;x2 =4.80,P=0.028),hemiplegia (97.14％ vs.72.55％;x2 =8.718,P=0.003),basilar artery stenosis (45.71％ vs.17.65％;x2=7.930,P=0.005) and poor outcome at discharge (54.29％ vs.31.37％ ; x2 =4.515,P =0.034),and the baseline National Institutes of Health Stroke Scale (NIHSS) scores (6.00 ± 2.39 vs.4.61 ± 3.41; t =2.087,P =0.040) in the PPI group (n =35) were significantly higher than those in the LPI group (n =51).The constituent ratios of the baseline diastolic blood pressure levels (97.82 ± 15.61 mm Hg vs.89.55 ± 12.23 mm Hg,1 mm Hg=0.133 kPa; t =2.258,P =0.031),PPI (63.64％ vs.32.81％ ;x2 =6.445,P =0.011) and basilar artery stenosis (59.10％ vs.18.75％ ;x2 =12.922,P =0.000) in the PMD group (n =22) were significantly higher than those in the non-PMD group (n =64).The baseline NIHSS scores (6.80 ± 2.63 vs.3.73 ± 2.55; t =5.426,P =0.000),fasting blood glucose levels (9.40 ±5.15 mmol/L vs.6.56 ±2.69 mmol/L; t =2.985,P=0.004) and the constituent ratios of PPI patients (54.29％ vs.31.37％ ;x2 =4.515,P =0.034) in the poor outcome group (n =35) were significantly higher than those in the good outcome group (n =51).Multivariate logistic regression analysis showed that basilar artery stenosis was an independent risk factor for the onset of PPI (odds ratio [OR] 3.801,95％ confidence interval [CI] 1.357-10.646; P =0.011) and the early PMD of isolated pontine infarction (OR 4.571,95％ CI 1.214-17.214; P=0.025).The baseline NIHSS score ≥ 5 was its independent predictor for poor outcome (OR 4.277,95％ OR 1.505-12.151; P =0.006).Conelusions PPI is mainly associated with the lesions in the branches of basilar artery.The baseline NIHSS score ≥ 5 may be an independent predictor for short-term poor outcome of isolated pontine infarction.Its early PMD and short-term poor outcome may be associated with the basilar artery lesions.

Visfatin is a recently discovered adipokine secreted by visceral adipose tissue,corresponds to pre-B cell colony-enhancing factor(PBEF), which is composed of 473 amino acid coding a 52kDa polypeptide and expressed in bone marrow,liver,muscle and so on.Visfatin binds and activates the insulin receptor,exerting insulin-mimetic effects;promotes adipose tissue to differentiate,synthesis and accumulate,which is correlated with obesity;promote vascular smooth muscle cell to mature,participating in the processes of inflammatory response and cell differentiation and apoptosis.The multi-function of visfatin increases new contents of correlated disease pathogenesis and new targets of disease management.

The relationship between C936T polymorphism at 3'-untranslated region of vascular endothelial growth factor (VEGF) gene and diabetic nephropathy (DN) was analysed in 194 type 2 diabetic patients. The frequencies of genotype CC and allele C were significantly higher in DN group than those in non-DN group and control group. Allele C and genotype CC of VEGF may be a genetic marker susceptible to DN.

Objective To evaluate diagnostic value of head upright tilt testing (HUTT) on orthostatic hypotension (OH) in patients with senile hypertension,and explore its efficacy and safety.Methods One hundred and sixty-six patients with senile hypertension were selected,and the patients were divided into 2 groups according to HUTT:experiment group (completed HUTT,86 cases) and control group (unfinished HUTT,80 cases).The blood pressure change was observed.The detection rate of OH and incidence of unexpected event were compared between 2 groups.Results The detection rate of OH in experiment group was 31.4％ (27/86),in control group was 17.5％ (14/80),and there was statistical difference (P ＜ 0.05).The incidence of unexpected event in experiment group was 0,in control group was 6.2％ (5/80),including 3 patients with dizziness amaurosis,unstable presyncope symptoms and fall,and 2 cases with syncope and sudden fall.There was statistical difference in incidence of unexpected event between 2 groups (P ＜ 0.05).Conclusions The use of HUTT in patients with senile hypertension can significantly improve the detection rate of OH,but also significantly reduce the incidence of unexpected event.The method is safe,effective,worthy of clinical promotion.

Objective Cystatin C (CysC) is a cysteine protease inhibitor,is widely expressed in human eukaryotic cells,CysC involved in diabetic nephropathy,retinopathy,peripheral vascular disease and type 2 diabetes,insulin resistance occurs Development,as a predictor of type 2 diabetes and complications

Diabetic mellitus induced erectile dysfunction (DIED) is a common complication of type 2 diabetes mellitus (T2DM), which seriously affects the physical and mental health of male T2DM patients. The occurrence of DIED involves a variety of pathophysiological changes such as vascular tissue, nerve, endocrine and so on. But the traditional treatment of erectile dysfunction is not ideal for DIED. Glucagon like peptide (GLP)- 1 receptor agonist has been widely used as a new drug for the treatment of diabetes, and the representative drugs are exenatide and liraglutide. Existing research shows that it can improve endothelial cell function, neuropathy and sex hormone secretion, reduce body weight and insulin resistance. Therefore, these drugs may be a new choice for patients with DIED.

BACKGROUND:Keloid is a very chalenging problem in plastic surgery. Its pathogenesis is very complex, resulting from the combined action of many factors, such as various cytokines, signal transduction pathways, extracelular matrix,etc. At present, a critical role for mechanical force and mechanotransduction in the pathogenesis of keloids has been broadly concerned and becomes the focus of studying the pathogenesis of keloids.
OBJECTIVE:To summarize the progress of the mechanosignaling pathway involved in the pathogenesis of keloids in order to further understand the pathogenesis of keloids and provide new ideas for the prevention of keloids.
METHODS: The PubMed database and Elsevier database were retrieved for articles published from January 2000 to July 2014 by computer with key words of “keloid, molecular mechanism, mechanical stress, cutaneous scar, mechanobiology, mechanosignaling pathway” in English. A total of 23 articles were included which related to the molecular signal transduction mechanism and mechanosignaling pathway about keloids.
RESULTS AND CONCLUSION:The mechanosignaling transduction pathways, such as transforming growth factor-β/Smad, MAPK, integrin, Wnt/β-catenin, RhoA/ROCK and tumor necrosis factor-α/nuclear factor-κB signaling pathway, play an important role in the formation and development of keloids. A number of clinical trials have also shown the effectiveness of a part of mechanosignaling transduction pathway inhibitors in wound healing and reducing scar hyperplasia. The research about mechanosignaling transduction pathways involved in keloids has made some progress, but most stil remain in animal experimental stage. Secondly, various mechanosignaling transduction pathways about correlation and intersectionality stil need further studies to achieve a breakthrough in the prevention of keloids.

Objective To explore the relationship of the level of serum selenium and infantile diarrhea,provide foundation for establishing the therapeutic criteria.Methods Seventy-eight diarrhea children was enrolled in this study,6 -24 months old.Thirty children with acute diarrhea (AD group),26 children with persistent diarrhea (PD group) and 22 children with chronic diarrhea (CD group).The level of serum selenium was measured and compared with another 30 healthy children (control group) of matched sex and age.The level of serum selenium of CD group was compared before and after the recovery.Results The level of serum selenium in AD group and PD group had no significant difference compared with control group [ (51.34 ± 4.84),(48.14 ± 3.05 ) μ g/L vs.(55.08 ± 5.59 ) μ g/L ] (P＞0.05 ).But the level of serum selenium in CD group was significantly lower than that in control group [ (42.13 ± 5.16) μ g/L vs.(55.08 ±5.59) μg/L] (P＜0.05).After treatment for 1 month,the level of serum selenium in CD group was significantly increased than before treatment [ (53.76 ± 8.38 ) μ g/L vs.(42.13 ± 5.16) μ g/L ] (P＜0.05 ).Conclusions The nosogenesis of chronic diarrhea may relate with the level of serum selenium decrease.Therapeutic selenium supplement is important in children with chronic diarrhea.

Objective:To optimize the formula of 5-aminosalicylic acid enema in situ gel. Methods:5-Aminosalicylic acid ene-mas in situ gel was prepared using a cold dissolution method with carbomer as the gel matrix and xanthan gum as the thickener. A 32 full factorial design was used to investigate the effects of the concentrations of carbomer and xanthan gum on the viscosity before and af-ter the gelling, duration of inversion tube and sedimentation rate. Response surface methodology was used to optimize the formula. Re-sults:The quantitative relationships between the two factors and the four evaluation indices were obtained. The optimum formula was as follows:the concentration of carbopol and xanthan gum in the enema was 0. 7% and 0. 15%, respectively. The viscosity before and af-ter the gelling was 500-1 000 mPa·s and 2 200-2 700 mPa·s, respectively. The duration of inversion tube test was 40-80 min and the sedimentation rate was more than 98. 5%. Conclusion:The multi-objective simultaneous optimization of the formula of 5-aminosal-icylic acid enema in situ gel is accomplished by factorial design and response surface methodology.

AIM: To elucidate if the cytoprotective effects of IGF-1 and insulin on free fatty acid-treated pancreatic ? cells involve alteration in NF-?B activity.METHODS: Apoptosis was characterized by morphological analysis with invert microscope as well as Hoechst 33342 staining under a fluorescence microscope.Influence of co-incubation with free fatty acid(FFA) and IGF-1 or regular insulin(RI) on NF-?B activity were determined by Western blotting.Impacts of Bay-117082,which is NF-?B inhibitor,on cytoprotective effects of IGF-1 and RI were measured by flow cytometry.RESULTS: Apoptosis measured by flow cytometry was inhibited by IGF-1 and RI and semi-quantitative determination by Western blotting showed co-incubation with FFA and IGF-1 or RI caused more potent activation of NF-?B compared with incubation with FFA solely.Furthermore,flow cytometry showed suppression of NF-?B activity abolished the cytoprotective effects of IGF-1 and RI.CONCLUSION: Our data suggest that anti-apoptotic effects of IGF-1 and regular insulin on FFA-treated RIN-m cells are mediated via NF-?B pathway.