Objective To investigate the effect of pancreatic ? cell dysfunction on abnormal glucose tolerance during Graves hyperthyroidism. Methods We investigated 6 healthy people and 36 Graves disease patients with abnormal glucose tolerance, and determined blood sugar and insulin at 0, 60 and 120 minutes after breakfast respectively. Then the HOMA-IR, HOMA-? and ISI were compared between the two groups. Results The HOMA-IR in the Graves disease patients with abnormal glucose tolerance is evidently higher than in the healthy subjects (P

Objective To investigate the synergetic effect of combined astaxanthin ( AST) and lith-ium chloride ( LiCl) treatment on cognitive dysfunction of chronic omethoate poisoned mice. Methods 8 mice were selected randomly as control group from 55 healthy adult male Kunming mice,and the rest were used to establish chronic organophosphate poisoning cognitive impairment models by injecting omethoate 5 mg/kg subcutaneously every day for 4 weeks. Totally 40 successfully established models were randomly divid-ed into model group,AST group,edaravone group,LiCl group and AST+LiCl group with 8 in each. Morris wa-ter maze test was used to examine the learning and memory ability of mice. Contents of reactive oxygen spe-cies (ROS) in hippocampus were measured by enzyme-linked immunosorbent assay (ELISA). Activity of superoxide dismutase ( SOD) in hippocampus was measured by colorimetric assay. Morphology of hippocam-pus area was observed by HE staining. The distribution and expression of p-PI3K,p-Akt,p-GSK3β and p-CREB were determined by immunohistochemical staining ( IHC staining) and Western blot. Results The average escape latency of 5 days in each group was statistically significant (F=1662.147, P<0.05) . The av-erage escape latency of 5 days in AST+LiCl group was significantly lower than that in model group ( all P<0.05) and was lower than other treatment groups. Compared with the control group (0.087±0.007,0.084± 0.009,0.097±0.002,0.076±0.012),the hippocampal neuronal injury in model group was serious,the expres-sions of p-PI3K (0.032±0.008),p-Akt (0.03±0.006),p-GSK3β (0.028±0.007) and p-CREB (0.020± 0.008) was significantly lower ( all P<0.05) . The injuries of hippocampal neurons in AST+LiCl group were slightly lighter than that in model group,and the expression of p-PI3K (0.067±0.008),p-Akt (0.065± 0.005),p-GSK3β (0.068±0.009) and p-CREB (0.062±0.008) in hippocampus was significantly higher than that in model group ( all P<0.05) . Conclusion Combined AST and LiCL treatment exerts neuroprotec-tive effect on cognitive dysfunction induced by chronic organophosphate poisoning via up-regulating the ex-pression of Akt/GSK3β/CREB.

OBJECTIVE: To compare inhibition effects of arsenacetylic acid(ASAC) on experimental H22 hepatoma-bearing mice in different forms of administration. METHODS: The mice were divided into 5 groups at random after inoculated with H22 hepatoma into their right axillas hypodermic by intraperitoneal injection(ip) and intravenous injection(iv), and then injected with normal saline,cyclophosphamide and different dosage of ASAC, observe the rate of tumor strain becoming tumor, the inhibition effects of the subjects and the effects of the subjects on mice's viscera. RESULTS: Compared with ip,either high, moderate or low dosage of ASAC by iv did have an obvious inhibitory effect on tumor and the tumor inhibition rates were 46.59%, 46.31% and 32.48% respectively; however, the spleen index in groups that of lower dosage of ASAC by two forms of drug administration were increased; there were death by poisoning in the group that iv with high dosage of ASAC.CONCLUSION: Compared with ip, the administration of ASAC by iv has a better effect on tumor.

Objective To provide data for reference on the impact of cyclosporin A (CsA) on the proliferation of the bone marrow mesenchymal stem cells in MDS patients through the investigation of the impact of cyclosporin A on human bone marrow mesenchymal stem cell proliferation. Methods The absorption rates of the bone marrow mesenchymal stem cells in the control group and the MDS patient group were determined by using the tetrazolinm salt (MTT) micro-colorimetric enzyme reaction. The concentrations of cyclosporine A are 2.5×10~4 ng/μl, 2.5×10~3 ng/μl, 2.5×10~2 ng/μl and 2.5×10ng/μl respectively. Results There is no significant difference between the each result by using different concentrations of CsA., which indicates the impact of CsA on the growth of mesenchymal stem cells is not significant(P >0.05). In the serial of concentrations mentioned, no cytotoxicity of CsA is observed. However, there is difference between the selected indicators of the control group and the patient group (P <0.01), and the value of the MDS patient group is higher than that of the control group. There is no statistic difference between the concentration of CsA and the data obtained from interactions between different groups (P >0.05). There is no significant difference between the absorption rates of the group treated by CsA of every concentration and the corresponding control group. Conclusion The impact of CsA on the bone marrow mesenchymal stem cell proliferation is significant in neither healthy people nor MDS patients.

Objective To evaluate the impact of three to four cycles of neoadjuvant chemotherapy (NACT) on the survival of patients with N2-N3 nasopharyngeal carcinoma (NPC).Methods The clinical data of 915 patients with T1-4N2-3M0 NPC from 2007 to 2010 were retrospectively analyzed.A total of 179 patients treated with 3-4 cycles of NACT (NACT≥3 group) were matched with 358 patients treated with 2 cycles of NACT (NACT=2 group) and 179 patients treated without NACT (NACT =0 group,concurrent chemoradiotherapy group) for age,N stage,pathological subtype,and NACT regimen.The Kaplan-Meier method was used to calculate overall survival (OS),disease-free survival (DFS),recurrence-free survival (RFS),and distant metastasis-free survival (DMFS) rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox proportional hazards model was used for multivariate prognostic analysis.Results For the NACT≥ 3,NACT =2,and NACT =0 groups,the 5-year OS rates were 89.4％,81.6％,and 73.7％,respectively (P=O.000),the 5-year DFS rates were 83.2％,69.8％,and 64.2％,respectively (P=O.000),the 5-year RFS rates were 86.0％,76.0％,and 69.3％,respectively (P=0.001),and the 5-year DMFS rates were 86.6％,76.0％,and 68.3％,respectively (P=0.000).Three to four cycles of NACT was an independent protective factor for OS,DFS,RFS,and DMFS in patients with N2-N3 NPC.Conclusion Three to four cycles of NACT can significantly improve the survival of patients with N2-N3 NPC.

Objective We analysed the homocysteine level and distribution of ganzhou city crowd ,learned about its elevatory sit‐uation ,and provided theory basis for the intervention of high homocysteine level crowd and the prevention of heart and head blood vessel disease .Methods We detected the blood homocysteine level of 6419 adults who had physical examination in our hospital dur‐ing 2012 by enzymatic methods ,and analyzed the diagnose rate of HHcy and the distributions of Hcy in different age and gender . Results The total detection rate of high homocysteine level in 6419 adults was 39 .11% ,among which 47 .30% in male and 22 .49% in female ,the comparison was statistically significant (χ2 = 424 .28 ,P< 0 .05) ;the detection rate of male was higher than female .In different ages ,the detection rates were statistically significant comparatively (P< 0 .05) .The detection rate of homocys‐teine level in both gender rises with age .At the same time ,homocysteine levels in males of 25 - 34 years old age group and 35 - 44 years old age group ,45 - 54 years old age group and 55 - 64 yeas old age group were not statistically significant ;while there were statistical differences of Hcy level in the rest age groups of male ,different age groups of female and same age different gender groups (P< 0 .05) .Conclusion The HHcy detection rate and the blood Hcy distribution of Ganzhou city crowd has its regional characteristics compared with other regions ,and it may be associated with the main population distribution of hakka people and oth‐er geological factors .The detection rate of HHcy was relatively high ,and it′s advisable to take early prevention to lower the risk of heart and head blood vessel disease .

An iodine analysis instrument with sequential injection of urine samples was developed. A method for measurement of urine iodine was also developed by combining sequential injection and catalysis kinetics,and making use of catalysis facilitation of the iodine in the redox reaction of As~(3+) and Ce~(4+) . The sequential injection and stopped-flow stabilization determination were made possible by the program-controlled injector with controlled flow rate and the 16-hole program-controlled selection valves. The arsenic-cerium reaction with iodine-catalyzed at constant temperature state might proceed with the constant temperature flow cell. Using the syringes with program-controlled velocity,pushing and suction,Using the digital connected circuit and micro-iodine determination software,the reaction temperature of (32.0±0.1)℃,injection time of 45 s,stabilization time of 60 s,detection time of 20 s,injection volume of 400μL,linear range of 15 -600μg/L,detecting limitation of 5.01 μg/L(n=11) and recovery rate of 94. 1 % - 105. 1 % were obtained. With this method,the detecting result of the National Standard Reference (GBW09109 and GBW09110) materials was within a given standard range. Through this method,the detecting results had no significant differences comparing with those by standard method of National Health Service(P >0.05).

Objective To explore characteristics of sleep structure and the correlation with cognitive function in cerebral infarction combined with obstructive sleep apnea hypopnea syndrome (CI-OSAHS).Methods The patients with CI-OSAHS and OSAHS in Department of Neurology and Breathing Sleep Monitoring Room of Tianjin Medical University General Hospital from December 2009 till March 2011 were collected All the patients completed polysomography(PSG).Sixty patients were selected and divided into 3 groups based on PSG.These 3 groups were combined group 20 persons (CI-OSAHS),OSAHS group 20persons (OSAHS) and control group 20 persons (without cerebral infarction obstructive sleep apnea hypopnea syndrome).All the patients completed image examinations ( CT and MRI ) evaluation of the cognitive function by Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA).Results Sleep structure:the awake time,non-rapid eye movement sleep (NREM) 1,NREM 2 and NREM periods in combined group and OSAHS group were significantly longer,the NREM3 + 4 and rapid eye movement(REM) periods were shorter than the control group.The NREM and NREM 1 periods in combined group were longer,the NREM 3 +4 and REM periods were shorter than the OSAHS group.The correlation analysis of cognitive function and breathing disorders and low oxygen related index:there was negative correlation between the total scores of cognitive function (MMSE and MoCA)and apnea hyponea index,oxygen desaturation index (ODI) ( MMSE r =-0.450,-0.671,MoCA r =-0.486,- 0.494,all P ＜0.05) while,was positive correlation between them and noctumal average hypoxemia and minimum hypoxemia ( MMSE r =0.477,0.485,MoCA r =0.507,0.482,all P ＜0.05) in the OSAHS group.There was negative correlation between ODI,arousal index and the total scores of MoCA in the combined group (MoCA r=-0.463,0.480,both P＜0.05),there was correlation between the total scores of MMSE and the other sleep parameters,but,there was no difference in statistics.The correlation analysis of cognitive function and sleep stages:There was positive correlation between the total scores of cognitive function ( MMSE and MoCA) and the NREM 3 + 4 periods ( r =0.521,0.474,both P ＜ 0.05 ) while,there was negative correlation between the total scores of MMSE and the N REM 1 + 2 periods (r =-0.458,P ＜ 0.05 )in the OSAHS group.There was positive correlation between the REM period and the total scores of MoCA (r =0.472,P ＜ 0.05 ).There was correlation between the total scores of MMSE and the sleep structure,but,there was no difference in statistics in combined group.Conclusions Patients with OSAHS have obvious sleep structure disorder.The awake time and light sleep periods are significantly longer than the control group,while,the deep sleep and REM periods are significantly shorter than the control group.The NREM 1 of the patients with CI-OSAHS is longer than the patients with OSAHS.The higher the AHI,the lower the night blood oxygen,the more obvious cognitive dysfunction The longer the awake time,the longer the light sleep,the shorter the deep sleep and REM periods,the more serious cognitive dysfunction.The correlation between the cognitive impairment and low oxygen is more apparent than sleep structure.There is apparent correlation among the total scores of MoCA,the degree of hypoxia and sleep structure in the patients with CI-OSAHS.The total scores of MoCA are more sensitivity than MMSE in mild vascular cognitive impairment.

Xu XP,Xiao N);Department ofGeneral Surgery,Pingxiang People's Hospital,Pingxiang,Jiangxi 337000,China(Rong J) Objective To study the expression of vascular endothelial growth factor(VEGF),S100A4 and survivin in thyroid carcinoma and their clinical significance.Methods The expression of VEGF,S100A4 and survivin in normal thyroid tissues from 28 people and thyroid cancer tissues obtained from 73 patients were detect by immuno-histochemistry method.Results The positive rates of VEGF,S100A4 and survivin in thyroid cancer were 84.93%, 86.30% and 79.45%,which in the normal thyroid tissues were 3.57%,7.14% and 14.29%,respectively.There were significant differences between every two groups,thyroid cancer and the normal thyroid tissues,statistically(χ2 =57.08,55.28,36.26,all P =0.000).VEGF,S100A4 and survivin in the positive expression of capsular infiltration carcinoma group were 97.37%,97.74%,97.74%,which in lymph node metastasis positive group cancer rates were 97.30%,94.60%,97.30% were significantly increased compared with no capsular infiltration group (71.43%, 77.14%,62.86%,respectively)and lymph node metastasis group(72.22%,77.78%,61.11%),the differences were statistically significant(χ2 =8.96,4.37,14.63,9.58,4.77,11.34,all P <0.05);the positive expression rate of three with thyroid cancer histological grade increased.Conclusion VEGF,S100A4 and survivin are closely related to the aggressive and metastatic character of thyroid cancer.A combination of VEGF,S100A4 and survivin may be of grate significance for predicting high aggressive and metastatic character in thyroid carcinoma.

Objective Subject To summary the port placement and system set-up for robotic minimally invasive heart surgery using da Vinci S system in China. Methods 400 patients accepted selective robotic minimally invasive heart surgery from January 2007 to January 2011. We conducted a retrospective review of port placement and system set-up for all the surgeries. During the surgery 3-4 ports were made in the lateral thoracic wall and the position of ports were modulated according to the types of diseases, the procedure and patients' habitus. The surgeon completed the procedure before the surgeon console.The arms of da Vinci S system was adjusted according to surgery procedure. Results The right lateral ports were suitable for the intracardiac operation with extracorporeal circulation. And the left lateral ports can be used in the inner thoracic artery harvesting and coronary bypass graft on beating heart. Except for 1 case changed to sternotomy because of sever pleural adhesions,no arms collision and mechanical malfunction during the surgery that leaded to surgical conversion. Conclusion Robotic minimally invasive heart surgery can be safely applied to partial cardiac surgeries. The port position and system set-up should be adjusted according to the habitus of patients and surgical requirement.