Objective To study whether the protective effects of fenofibrate on insulin resistance in mice of nonal-coholic fatty liver disease(NAFLD) are related to endoplasmic reticulum stress (ERS). Methods Male C57BL/6 mice were fed with high-calorie and high-cholesterol diet ( HCD) to induce a model of NAFLD, then one of those two groups from HCD was treated with fenofibrate 40 mg/( kg · d ) for 2 weeks ( HCF ) . Glucose tolerance test (GTT) and insulin tolerance test (ITT) were used to analyze the improvement on insulin resistance. The serum levels of triglyceride ( TG) , total cholesterol ( TC) , high density lipoprotein-cholesterol ( HDL-C) , low density lip-oprotein-cholesterol ( LDL-C) , alanine aminotransferase ( ALT) and aspartic transaminase ( AST) were detected. The pathological changes of livers were detected with HE and Oil Red O staining, the mRNA and protein expression of peroxisome proliferator-activated receptorα( PPARα) , glucose regulated protein 78 ( GRP78 ) and transcription factors GADD153 ( CHOP) were detected with real-time quantification PCR and Western blot analysis respectively. Results Compared with the SCD mice, the HCD mice showed significant insulin resistance, higher serum levels of TG, TC and LDL-C (P<0. 01, P<0. 05), lower serum level of HDL-C (P<0. 01), micro-and macrovesicular steatosis, ballooned hepatocytes and infiltration of inflammatory cells were observed in the liver, the expressions of PPARα and GRP78 at mRNA and protein levels were decreased (P<0. 05), however, the expressions of CHOP at mRNA and protein levels were increased ( P<0 . 05 ) . Fenofibrate intervention significantly improved insulin resist-ance and decreased the serum level of TG ( P<0. 05 ) . Fenofibrate also alleviated hepatic steatosis and inflammato-ry infiltration, and increased the mRNA and protein expressions of PPARα and GRP78, decreased the mRNA and protein expression of CHOP ( P<0 . 05 ) . Conclusion Fenofibrate significantly improves insulin resistance and de-creases the serum level of TG in NAFLD mice, which may be related to activating PPARα and relieving ERS.

Background As myopia is a common ocular condition which has been reported as the risk factor of primary open angle glaucoma,it is of great importance to evaluate the optic disc morphology in myopic eyes.Objective This study was to evaluate the agreement of optic disc measurements between Cirrus high-density optical coherence tomography (HD-OCT) and Heidelberg retina tomograph (HRT) in myopic eyes;and to investigate the relationships between axial length (AL) and differences of optic disc parameters measured with the two devices.Methods One hundred and fifty myopic subjects were included in this prospective cross-sectional study.One eye from each subject was randomly selected for optic disc imaging by Cirrus HD-OCT and HRT2 in Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong from September to December in 2010 under the approval of Ethic Committee of this hospital and informed consent of each patient was received.Each subject received complete ophthalmic examinations including intraocular pressure (IOP) measurement,visual acuity,refraction,slit lamp,dilated fundus examination and perimetry.The subjects were divided into low (≤-3.00 D,35 eyes),moderate (-3.00 D＜SE＜-6.00 D,60 eyes) and high myopia (SE ≥-6.00 D,55 eyes) groups according to the refractive status.Measurement of axial length was performed with IOL master.Optic disc parameters including disc area,rim area,cup volume,vertical cup-to-disc ratio (VCDR) and average cup-to-disc area ratio (ACDR) were measured by Cirrus HD-OCT and HRT2,respectively.The OCT measurements were corrected for ocular magnification using the Littman's formula,and the results were compared between the instruments.The measurement agreement was evaluated using Bland-Altman plots.Pearson correlation analysis was used to evaluate the associations between AL and the measurement differences of the two instruments.Results The mean axial length and refraction were (25.62±1.10) mm and (-5.22±2.34) D,respectively.The corrected optic disc parameters were significantly larger than those without adjustment by using Cirrus HD-OCT (all at P＜ 0.001).In the high myopic group,the disc area measured by Cirrus HD-OCT was significantly larger than that by HRT2 (P＜0.001).In the moderate myopic group,the rim area measured by HRT2 was significantly larger than that by the Cirrus HD-OCT (P =0.040).The measurements of ACDR,VCDR and cup volume by Cirrus HD-OCT were all larger than those by HRT2 in the three myopic groups (all at P＜0.001).The 95％ limits of agreement (LoA) of disc area and rim area with the two devices were-0.64 to 0.74 and-0.74 mm to 0.62 mm2,respectively.The differences of disc area,rim area and cup volume measurements from the two devices were significantly and positively associated with axial length (r=0.158,0.148,0.156,all at P＜0.05).No significant correlation was detected between AL and the differences of ACDR and VCDR (r =0.012,0.093,both at P ＞ 0.05).Conclusions Optic disc parameters measured by Cirrus HD-OCT are affected by optical magnification in myopic eyes.Poor agreement is found across all of the disc measurements with Cirrus HD-OCT and HRT2.The two devices should not be used interchangeably for measurements of optic disc.Moreover,the differences between measurements of the two devices are significantly associated with AL.

Objective To analyze the immunogenomic characteristics of antibody repertoire in re-sponse to influenza vaccine in order to provide a theoretical basis for further development of antibody. Meth-ods Based on a time-series immunoglobulin heavy chain ( IGH) repertoire sequencing dataset, we analyzed the immunogenomic characteristics of antibody repertoire in response to trivalent influenza vaccine ( TIV ) from three aspects which included the features in complementarity-determining region 3 ( CDR3 ) , antibody mutation and VDJ usage. Results The frequency of antibody mutation increased significantly upon vaccina-tion. Analysis of the CDR3 region indicated that polar and aromatic amino acids had a higher preference. The length of CDR3 region in naive B cells followed a normal distribution, while specific CDR3 sequences with 15 to 18 amino acids in length occupied a dominant position after vaccination. In addition, the VDJ us-age altered obviously and IGHV3-7-derived antibody had a significant response to the vaccine. Response in-tensity reached the peak on day 7 and gradually weakened over time. Conclusion Antibody repertoire evolves dynamically to express specific antibody upon vaccination and the characteristics of immune responses at sequence level could be used to evaluate their effectiveness.

Objective To investigate the necessity and tolerance of operation for hip fracture in patients aged 75 years and over. Methods The general tolerance including the self-care ability, comorbidities and postoperative complications was retrospectively analyzed in 70 elderly patients with hip fracture. Then the relationship between operation and survival status was estimated. Results The average tolerance score was significantly higher in 46 patients who accepted the operation than in 24 patients who didn't C(76. 1±12. 2) vs. (65. 5±13. 9), P<0. 01]. The median survival period was significantly higher in operation group than in non-operation group ( 97 mouths vs. 48 mouths, P< 0. 05). Kaplan Meier analysis showed that the survival status was better in operation group than in non-operation group. Conclusions For elderly patients over 75 years old with hip fracture, comprehensive evaluations of surgical tolerance before operation are very important for assessing the perioperative risk and feasibility of surgery. The operative treatment is a reasonable choice, as long as the operation is well tolerated by the patients.

Objective To evaluate the effects of recombinant human bone morphogenetic-2-polylactide sustained release nanospheres (rhBMP-2-PLA-Ns) on cultured rabbit osteoblasts in vitro. Methods Rabbit osteoblasts were cultured in vitro, and rhBMP-2-PLA-Ns was added into the medium of the third generation of rabbit osteoblasts. The expression of the proliferating cell nuclear antigen (PCNA) was examined by immunofluoreacence staining, and the formation of tuberculums observed with alizarin red staining. Western blot was used to detect the effects of rhBMP-2-PLA-Ns on the expression of vascular endothelial growth factor (VEGF), which was compared with that in rhBMP-2 group and blank group. Results There was no significant difference in the number of osteoblasts with positive PCNA expression among three groups five days later. Ten days later, the number of osteoblasts with positive PCNA expression in rhBMP-2-PLA-Ns group was significantly higher than that in rhBMP-2 group and blank group, which indicated that rhBMP-2-PLA-Ns could enhance the expression of PCNA. Compared with rhBMP-2 group and blank group, rhBMP-2-PLA-Ns could significantly enhance the formation of tuberculums, with statistical difference (P<0.05). The expression of VEGF was detected in all three groups, and the level of the VEGF expression in rhBMP-2-PLA-Ns group was significantly higher than that in the other 2 groups (P<0.05). Conclusion The biological activity of rhBMP-2-PLA-Ns is superior than that of rhBMP2, and rhBMP-2-PLA-Ns can promote the proliferation, mineralization of osteoblasts and the secretion of VEGF, which has a better prospect in facilitating traumatic bone healing.

Objective To investigate the association of uncoupling protein 2 ( UCP-2 ) gene promoter -866G＞A polymorphism and ischemic stroke in diabetic patients.Methods A total of 844 type 2 diabetic patients including 404 cases with ischemic stroke and 440 cases without ischemic stroke were selected for the 4 year prospective study,Genomic DNA was extracted from the whole blood samples of subjects,UCP-2 gene promoter -866G ＞ A polymorphism was detected by TaqMan MGB probe method,and then the genotype and allele gene frequencies were compared.Results The risk of ischemic stroke in type 2 diabetic female patients with AA+GA genotypes of UCP-2 was higher than that with GG genotype (P＜0.05),but there was no difference among male patients with three genotypes.Conclusions UCP-2 gene promoter -866G ＞ A polymorphism increases the risk of ischemic stroke in Chinese diabetic women.

Objective To report microsurgical treatment of severed palm caused by crush injury. Methods From 1998 to 2002, 14 patients with severed palm and destructive crush injury were treated in our hospital. According to the specific severity and level of different injuries, replantation of severed palm with vessel transfer, replantation of fingers to the distal forearm with resection of wrist and palm, replantation of severed palm combined the thumb reconstruction were applied to reserve a maximal part of hand or fingers. Results Of the 14 cases of replantation, 3 experienced death of middle or index finger and the others all survived. The follow up of 11 cases lasted more than 6 months. After functional exercises, 10 cases recovered the function of pinch, and 1 case nearly regained normal functions. All of them regained sensation and the two point discrimination was 8 to 10 mm. Conclusion Reasonable replantation for severed palm with crush injury is still a method to regain part of hand functions.

Objective To probe the new mechanism of simvastatin on high-fat diet-induced kidney dam-age. Methods Female SD rats were subjected to a standard control diet(SCD)or high-fat diet(HFD)for 20 weeks,then the HFD group was randomly divided into HFD group and HFD group with simvastatin treatment (HFD+ST,10mg·kg-1·d-1 )for another 8 weeks. The expression of adiponectin,adiponectin receptors R1 and R2, Adenosine 5′-monophosphate(AMP)-activated protein kinase(AMPK),peroxisome proliferator-activated receptorα(PPARα),glucose regulated protein 78(GRP78)and GADD153(CHOP)in kidney were assessed respective-ly. Results Body weight and serum lipid levels in HFD group significantly increased ,expression of adiponectin and its receptors significantly down-regulated. Phosphorylation of AMPKα and PPARα expression decreased,and expression of GRP78 and CHOP up-regulated significantly. Above indexes in simvastatin treatment groups improved significantly. Conclusion Simvastatin can improve high-fat induced kidney damages ,probably by increasing expression of adiponectin and its receptors ,decreasing endoplasmic reticulum stress.

Objective To study the changes of the bone density and metabolic makers in patients with lupus nephritis (LN) after long time prednisone treatment.Methods All patients were women.The healthy controls (group A, n =20),the patients with normal renal function (group B, n =25) were studied before and after 2 and 4 month prednisone treatment.Dual energy X ray absorptiometry was used to measure bone mineral density (BMD) in the lumbar spine at L2～L4,femoral neck,Ward′s triangle,great trochanter (GT) and ultradis (ULT).Simultaneously,the serum calcium,phosphate,alkaline phosphate enzyme,PTH M,BGP,24 hour urine calcium,creatinine and other biochemical indices were examined in all of them.Results ① There were no significant differences in BMD between both groups ( P

Objective To explore the relationship between quality of life and sub-health state of Guangdong urban dwellers.Methods A total of 2 200 urban dwellers were investigated using SF-36 and Sub-Heahh Measurement Scale Version 1.0(SHMS V1.0).Results As for the scores in PCS,MCS,psychosocial symptom,cognitive function,social adaptability,those of man urban dwellers (respectively (78.89± 15.25),(73.15 ± 15.26),(63.73± 18.82),(62.13± 19.34),(68.04± 17.90)) were higher than those of woman dwellers (respectively(76.98± 14.20),(71.76± 14.72),(60.53± 18.28),(57.00± 17.89),(65.73± 17.07)).The difference was statistically significant (P＜0.05).Bivariate correlation analysis showed that the PCS and MCS of quality of life were positively related with all dimensions of sub-health (P＜0.001).Canonical correlation analysis indicated that vitality,social adaptability,psychosocial symptom and positive emotion were the main factors of sub-health status,and MCS was of quality of life.Conclusion Sub-health state of Guangdong urban dwellers is positively related with quality of life,and the more serious sub-health state is,the worse quality of life is.Therefore,intervention of subhealth and quality of life should be targeted to be strengthened according to the investigation.