Objective To investigate the effect of enhanced recovery after surgery (ERAS) on stress hyperglycemia in patients after pancreaticoduodenectomy (PD). Methods Patients matched inclusion and exclusion standards were divided into two groups. The patients after PD before the implementation of ERAS programme were named as the control group (40 cases). The patients after PD with the implementation of ERAS programme were named as the experimental group (52 cases). The fast blood glucose (FBG) in postoperative day (POD) 1, 3, 7 and the volatility of capillary blood glucose during postoperative 3 days were compared between the two groups. Results The FBG in POD1, POD3, POD7 were (8.27 ± 1.99), (6.78 ± 1.22), (5.97 ± 1.21) mmol/L in the experimental group respectively, and the FBG in POD1, POD3, POD7 were (10.46 ± 5.17), (7.88 ± 2.98), (7.29 ± 2.94) mmol/L in the control group respectively, there were significant differences between two groups (t=2.545, 2.219, 2.683, all P<0.05). The volatility of capillary blood glucose during postoperative 3 days in the experimental group were (3.47± 1.98), (3.16 ± 1.46), (2.74 ± 1.49) mmol/L respectively, and the volatility of capillary blood glucose during postoperative 3 days in the control group were (4.13±2.36), (3.26±1.59), (4.07±2.74) mmol/L respectively, no significant differences were found in the volatility of capillary blood glucose in POD1 and POD2 between the two groups (t=1.479, 0.308, all P > 0.05), while significant differences were found in the volatility of capillary blood glucose in POD3 between the two groups (t=2.739, P<0.05). Conclusions It can be concluded that ERAS may be useful to decrease stress hyperglycemia and the volatility of capillary blood glucosein patients after PD, and accelerate the recovery of patients after PD.

Objective To study the effects of RNA interference(RNAi)-mediated silencing of mitofusin-2 (Mfn2) gene on glycornetabolism and insulin resistance in BALB/c mice. Methods Mfn2 short hairpin RNA (shRNA) and negative control green fluorescent protein(GFP) -expressed plasmid vectors were constructed. 44 mice were randomly divided into transfection group (Mfn2) and negative control group (HK). 1.5 ml GFP-expressed plasmid(negative control or Mfn2 shRNA,75 μg for each mouse)was injected into the mice in 5 seconds through vena caudalis. Five days later, intraperitoneal glucose tolerance test (IPGTT) and intraperitoneal insulin tolerance test(IPITT)were performed to evaluate glycometabolism and insulin sensitivity. D-3-[3~H]-glucose in PBS buffer were injected via the tail vein. Blood samples were taken at specific time points. Radioactivity was measured in all samples with liquid scintillation counter. The rates of hepatic glucose production in vivo were calculated. Mfn2 protein expression in hepatic tissue was detected by Western blot. Results Compared with HK mice, the Mfn2 expressions of Mfn2 mice decreased markedly(8.05±0.15 vs 8.56±0.01 ,P<0.05). The fasted blood glucose leves [(6.95±0. 83 vs 4.68±0. 29) mmol/L,P<0. 05] in Mfn2 mice were higher than those in HK mice. The insulin sensitivity of Mfn2 mice decreased markedly compared with HK mice. The rate of hepatic glucose production was significantly elevated in Mfn2 mice [(49.53±16.31)μmol·kg~(-1)·min~(-1)],compared with negative control mice[(24.91±4.07)μmol·kg~(-1)·min~(-1),P<0.05].Conclusion The down-regulatd expression of Mfn2 induces glycometabolic disorder and insulin resistance in BALB/c mice. Mfn2 plays an important role in maintaining glucose homeostasis in vivo.

Purpose: To explore the therapeutic methods and effects in the treatment of acute and chronic injuries of the ankle joint by Chinese massage therapy in combination with external application of Chinese herbal drugs and functional exercises. Methods: Totally, 36 cases of the patients with acute soft tissue injury, chronic soft tissue injury and post-fracture sequelae of the ankle joint were treated by Chinese massage therapy, external application or external wash of Chinese herbal drugs, and exercises of dorsal flexion and extension of the ankle joint, to observe the restoration of the ankle functions.Results: In 36 cases of the patients, the results showed remarkable effect in 18 cases, effect in 16 cases, failure in 2 cases and the effective rate in 94.4%. Conclusion: The combined use of Chinese massage therapy, external application of Chinese herbal drugs and functional exercises can produce precise effect in the treatment of soft tissue injury of the ankle joint.

The cytochemical method of Ca-ATPase activity was studied in this article. The native made reagent was utilized and worked in our department, The appearance of Ca-ATPase activity was researched for the cells of hepar, kidney, brain and oviduet, especially for the membrane system of myocardium cell.

Objective To explore MRI features of incontinentia pigmenti(IP) in central nervous system (CNS) in newborn infants.Methods MRI and clinical data of 17 cases of IP which confirmed by clinic,skin biopsy or NEMO gene test were analyzed retrospectively.Results There were 17 cases with IP in this study.MRI abnormalities were found in 12 cases, among which 3 cases showed high signal intensity on T2WI and a reduced signal intensity on T1WI,and 9 cases showed normal signal intensity on traditional MRI.Multiple areas of restricted diffusion were found in 12 cases which showed asymmetric high signal intensity in bilateral cerebral cortex and subcortical area, basal ganglia,centrum semiovale and periventricular area on DWI.In addition,basal ganglia was involved in 4 cases,corpus callosum was involved in 5 cases, and thalamus was involved in 2 cases.Conclusion MRI of IP in CNS shows certain specific characteristics.DWI plays an important role in the early detection and prognosis of the disease.

In order to investigate the impairment of mitochondrial membrane phospholipid localization and DNA(3867) (mtDNA(3867)) deletion and the correlation between cardiac and skeletal muscle cells in mice with viral myocarditis, 50 BALB/c mice were divided into two groups randomly. In experimental group (n=40), the mice were intraperitoneally injected with 0.1 mL Eagle liquid with CVB3(TCID50=10(8)), while in the control group (n=10), the mice were subjected to equal volume of Eagle liquid. The impairment of mitochondrial membrane phospholipid localization and mtDNA(3867) deletion rate of cardiac and skeletal muscle were detected separately at day 3, 11 and 24 after injection. The correlation of mitochondrial membrane phospholipid localization and mtDNA(3867) deletion rate between cardiac and skeletal muscle cells cells was analyzed using Spearman method. At the day 3 after injection, in both cardiac and skeletal muscle cells, mtDNA(3867) deletion rate was significantly higher in experimental group than in control group (P<0.05), but the localization of mitochondrial membrane phospholipid showed no difference between two groups (P>0.05). At day 11 after injection, the mtDNA(3867) deletion rate of both cells in experimental group was increased to the peak level (P<0.05), and the impairment of mitochondrial membrane phospholipid localization of both cells also increased markedly in experimental group as compared with control group (P>0.05). At the day 24 after injection, the impairment of mitochondrial membrane phospholipid localization and mtDNA(3867) deletion of both cells showed a recovery tendency, but still severer than those at the day 3 after injection (P<0.05). The impairment of mitochondrial membrane phospholipid localization and mtDNA(3867) deletion were consistent and synchronistic between cardiac and skeletal muscle cells, and showed good correlations (P<0.05). The impairment of mitochondria plays an important role in the pathogenesis of viral myocarditis, and the skeletal muscle cells might act as a peripheral "window" to reflect the mitochondrial damage of cardiac myocytes.

Objective To discuss the clinical feature of chronic pain of aged people and strategies and effect of its self-management as well as their relationship.Methods Investigation with questionnaires wag carried out in 243 aged people who were above 65 years old to understand the clinical feature of chronic pain and strategies of its self-management.The results underwent analysis.Results Non-narcotic analgesics,physical exercise,cold and heat therapy and spiritual activity were used most frequently in selfmanagement of pain.No statistical difference existed in the use of self-management strategies between people in different age groups.Effect of self-management strategies was negatively correlated with degree of pain,interrupting with daily life and anxiety,but Wag positively correlated with self-efficacy score.Conclusions Aged people ale willing to attemp various strategies to cope with chronic pain.We should pain attention to the standardization of physical exercise,confrontation of anxiety and improvement of self-efficacy to improve the effect of self-management.

Objective To observe the significance of tumor abnormal protein (TAP)in the therapeutic monitoring of non-small cell lung cancer (NSCLC).Methods Peripheral blood from 30 NSCLC patients were collected to make smears at the moment of pre-treatment,half a month,one month,3 months and 6 months after therapy.TAP was detected by coacervation method.The maximum area of condense was applied to estimate the level of TAP.Thirty healthy subj ects were chose as con-trol group.Results The positive rate of TAP in NSCLC patients was 86.67%,and 3.33% of healthy subjects were positive in TAP.The difference was statistically significant (χ2=140.3,P<0.01).The condense area of TAP in patients withⅢ~Ⅳ stage of NSCLC [411(89,562)mm2]was significantly higher than those withⅠ~Ⅱ stage NSCLC [267(31,407)mm2]. The condense areas in both of two groups went down after treatment.A significant difference of condense area appeared inⅠ~Ⅱ stage of NSCLC patients a month after therapy as well as Ⅲ~Ⅳ stage of NSCLC patients half a month after treat-ment.The condense areas went to their lowest level 3 months after therapy.ForⅠ~Ⅱ stage patients,the condense area fell to 21% compared to that before treatment,but for patients withⅢ~Ⅳ stage of NSCLC,37% of pre-treatment condense ar-ea were detected.TheⅠ~Ⅱ stage of NSCLC patients had a greater decrease in condense area of TAP than theⅢ~Ⅳ stage patients by 3 months after treatment (χ2=6.22,P<0.05).Conclusion Detection of TAP in peripheral blood had a high sensitivity for NSCLC,and is able to monitoring the treatment effect.

BACKGROUND:Tumor necrosis factor-α(TNF-α), a main cytokine inducing chondrocyte apoptosis of osteoarthritis, plays a regulatory role in the process of osteoarthritis. OBJECTIVE:To compare the rat models of chondrocyte apoptosis induced by different mass concentrations of TNF-α, thus providing theoretical basis for further study on the regulation of drugs on chondrocyte apoptosis. METHODS:Chondrocytes were isolated from the knee cartilage of 4-week-old Sprague-Dawley rats of clean grade by mechanical l col agenase digestion and were then incubated with different mass concentrations of TNF-αto induce apoptosis. The morphology of chondrocytes was observed under inverted phase contrast microscope, cel s were identified using immunohistochemical staining of type II col agen, as wel as the cel viability and apoptosis were detected by MTT and DAPI, respectively. RESULTS AND CONCLUSION:(1) In vitro, the cytoplasm of chondrocytes was stained brown-yel ow by using immunohistochemical staining of type II col agen. (2) At 48 hours, the apoptosis rate of chondrocytes induced by 10, 20 and 30μg/L TNF-αwas significantly higher than that of the 0μg/L TNF-α(P<0.01), and the apoptosis rate of chondrocytes induced by 40μg/L TNF-αwas significantly higher than that of the 10μg/L TNF-α(P<0.01). (3) The viability of chondrocytes induced by 10, 20 and 40μg/L TNF-αwas significantly lower than that of the 0μg/L TNF-α(P<0.01). In detail, the viability of chondrocytes induced by 20μg/L TNF-αwas lower than that of the 10μg/L TNF-α(P<0.05);the viability of chondrocytes induced by 40μg/L TNF-αwas significantly lower than that of the 10 and 20μg/L TNF-α(P<0.01, P<0.05). (4) These results suggest that 20μg/L TNF-αcan successful y induce the chondrocyte apoptosis model.

Objective To observe the effect of simvastatin on bone metastasis of breast cancer in nude mice model.Methods Sixty mice were divided into three groups randomly with 20 in each group.Mice were inoculated with MDA-MB-231 cells into the left cardiac ventricle.After 7 days,mice were treated with either simvastatin,saline,or nothing twice per week for 19 days.The area of osteolytic metastases was subsequently measured in long bones of all mice using an image analysis system.After sacrifice,parathyroid hormone-related protein (PTHrP) concentrations in bone marrow from all mice were determined using a two-site immunoradiometric assay.Osteoclast number expressed per millimeter of tumor/bone interface was assessed using an OsteoMeasure System.Measured data were compared with analysis of variance,and P ＜ 0.05 for the difference was statistically significant.Results The area of osteolytic lesions was significantly lower in mice treated with simvastatin compared with mice receiving saline and no treatment (0.51 ±0.18 mm2 vs 2.13 ± 1.24 mm2 vs 2.29 ± 1.22 mm2 ; F =15.600,P =0.002 ; F =15.673,P =0.001).In addition,treatment with simvastatin decreased the concentrations of PTHrP in bone marrow plasma (0.98 ±0.20 pmol/L vs 2.11 ±0.31 pmoL/L vs 1.99 ± 0.29 pmol/L; F =61.469,P ＜ 0.001 ; F =58.274,P ＜ 0.001) and the osteoclast numbers per millimeter of tumor/bone interface (4.00 ± 1.73 vs 11.40 ±4.93 vs 10.91 ± 3.87 ; F =17.820,P =0.001 ; F =17.184,P =0.002) compared with controls.Conclusion Simvastatin may reduce the production of PTHrP of breast cancer cells,which suppresses the development of destructive bone lesions as well as the growth of breast cancer cells in bone.