Objective To investigate the association of cytotoxic T lymphocyte associated antigen 4(CTLA 4) gene polymorphism with type 1 diabetes in Chinese Han population.Methods The A/G phenotype at position 49 of the CTLA 4 gene exon 1 was determined by polymerase chain reaction restriction fragment length polymorphism(PCR RFLP)method in 33 typical type 1 diabetes patients,57 latent autoimmune diabetes in adults(LADA) patients and 84 healthy control subjects of Chinese Han.Results The frequency of the CTLA 4/G 49 phenotype was significantly higher in type 1 diabetes patients than in control subjects(55.6% vs 36.9%, respectively, P =0.0005),but there was no significant difference between typical type 1 DM and LADA groups. Neither the presence nor the absence of G 49 allele influenced the occurrence of islet autoantibody(ICA) and glutamate decarboxylase antibody(GADAb).Conclusion The polymorphism of CTLA 4 gene exon1 confers susceptibility to type 1 diabetes. This association is independent of ICA and GADAb.

Objective To compare the endocrine and metabolic parameters between patients suffering from polycystic ovary syndrome (PCOS) with or without subclinical hypothyroidism.Methods One hundred and fifty-six PCOS patients and 47 healthy controls were enrolled.Height,weight,waist circumference,and hip circumference were measured and recorded.Fasting blood samples were collected for measuring luteinizing hormone (LH),follicular stimulating hormone (FSH),total testosterone,prolactin,estrogen,sex hormone binding globulin (SHBG),thyroidstimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4),blood glucose,serum insulin,triglycerides,total cholesterol,low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol (HDL-C).Body mass index,waist-to-hip ratio,LH-to-FSH ratio,and free androgen index (FAI) were calculated.Homeostasis model assessment of insulin resistance (HOMA-IR) and β cell function (HOMA-β) were assessed.All patients underwent ultrasound for diagnosing polycystic ovary.All the patients were subdivided into two groups in terms of TSH value:subclinical hypothyroidism group with TSH level ≥4.2 μIU/ml and non-subclinical hypothyroidism group with TSH level＜4.2 μIU/ml.The differences in endocrine and metabolic parameters were compared between two subgroups.Results Compared with healthy controls,the PCOS patients had significantly higher body mass index,waist-to-hip ratio,LH,LH-to-FSH ratio,total testosterone,FAI,TSH,and lower SHBG (all P＜0.05).The other indexes were not different between two groups (P＞0.05).24.4％ PCOS patients were diagnosed as cases of subclinical hypothyroidism.TSH,prolactin,and triglycerides levels were higher in PCOS patients with subclinical hypothyroidism than those without (P＜0.01).Whereas estrogen,FT3,FT4 were significantly lower(P＜0.01).The differences of other parameters were not significant between two groups(P＞0.05).The results of correlation analysis and TSH quartiles showed no significant linear correlation between TSH and sex hormones,lipids,insulin resistance indices (P＞0.05).Conclusions The incidence of subclinical hypothyroidism in all PCOS patients is 24.4％.Prolactin and triglycerides levels were higher in PCOS patients with subclinical hypothyroidism than those without.Whereas estrogen,FT3,FT4 were significantly lower.

BACKGROUND:Receptor-interacting protein 140-knockout mice are lean and resistant to high fat diet-induced obesity due to an increase in mitochondrial biogenesis, fatty acid oxidation and oxidative phosphorylation.
OBJECTIVE:To study the expression level of receptor-interacting protein 140 mRNA in adipose tissue of high fat diet-induced obese mice and the correlation with insulin resistance.
METHODS:Male C57BL/6J mice were randomly divided into control group and high fat diet group, and fed for 14 weeks separately. The mice of the two groups were weighed. Mice in high fat diet group whose body weight were 20%higher than average weight of control mice were selected as obese mice.
RESULTS AND CONCLUSION:A total of 12 mice in high fat diet group were recruited into the obesity group. The levels of triglycerides, total cholesterol, fast blood glucose and fast insulin in obesity group were significantly higher than those of control group (P<0.05 or P<0.01). The expression of receptor-interacting protein 140 mRNA in adipose was significantly higher in obesity group compared with the controls (P<0.05). Moreover, the expression of receptor-interacting protein 140 mRNA in adipose was positively correlated with triglycerides levels and insulin resistance index (r=0.526, P<0.05;r=0.465, P<0.05), but negatively associated with the levels of total cholesterol, fast blood glucose and fast insulin (P>0.05).

Objective　To investigate the association of gene polymorphism of cytotoxic T lymphocyte-associated antigen 4（CTLA-4） with autoimmune thyroid diseases. Methods　The A／G transition polymorphism at position 49（exon 1，codon 17） of the CTLA-4 gene was determined by polymerase chain reaction restriction fragment length polymorphism （PCR-RFLP）method in 122 autoimmune thyroid diseases patients which included 87 Graves’ disease （GD） patients and 35 Hashimoto's thyroiditis（HT） patients， as well as 84 control subjects. We detected their thyroid function by ELISA technique， and the thyroid autoimmune antibodies （TGAb，TPOAb） by indirect immunofluorescent technique. Results　The strong association of the CTLA-4／G49 allele with AITDs was seen in our study（66.4％ vs 36.9％ P＜0.0001）. The G allele in GD patients was significantly increased compared with control subjects（69.5％ vs 36.9％， P＜0.0001）. In HT patients， the frequency of G allele was also higher than control subjects（58.6％ vs 36.9％，P＜0.01）， and there was no significant difference between HT and GD groups. When GD and HT subjects were stratified with respect to sex， neither female nor male patients demonstrated evident association of G49 allele with gender.Conclusions　The polymorphism of CTLA-4 gene （exon 1 condon 17 position 49）confers susceptibility to AITDs. This association is independent of sex.

BACKGROUND:Pretreatment is a dominant way to increase the histocompatibility of biomaterials,but many pretreatments are not satisfactory due to some reactions,such as calcification,cytotoxic reaction and reducing the tension resistance.OBJECTIVE:To investigate the effect of immunogenicity,scaffold tension and cell growth factor on the non-pretreated scaffold biomaterials,and to prepare the homograft decellularized scaffolds.DESIGN:Contrast observation for the histomorphology.SETTING:The experiments were carried out in the Department of General Surgery,Affiliated Hospital of Nantong University from June 2006 to March 2007.MATERIALS:Wistar rats of SPF grade were adopted in this study.Sodium dodecyl sulfate from BioteehGrade Company(U.S.A.);basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) from Peprotech Company(UK);dynamometer from Suzhou Electrical Element First Factory (China).METHODS:The vena cava inferior from rats were selected as experimental materials,we decellularized the epithelial cells from vein according to the improved Booth's methods with low osmotic Tris buffer containing sodium dodecyl sulplate,and then reserved the extracellular matrix.After fixing,the decellularized scaffold was stained by hematoxylin and eosin,the collagen fibers were observed and photographed by light microscope and scanning electron microscope.Changes of the intensity of the scaffolds were measured before and after decellularization.The deceilularized scaffolds were transplanted subcutaneously at homogeneity rats to observe whether the scaffolds had induced immunological rejection.In combination with bFGF and/or VEGF,the scaffolds were transplanted subcutaneously at homogeneity rats and took out two weeks later,in order to exam the new vessels in the scaffolds by immunohistochemistry.Dynamometer was applied to compare the change of the intensity of the scaffolds before and after transplantation.MAIN OUTCOME MEASURES:Change of the intensity of the scaffolds after decellularization and transplantation.Formation of new vessels in scaffolds.Local rejection of the scaffold subcutaneously transplanted into rats.RESULTS:The endothelial cells of the vein were completely removed when incubated with Tris buffer containing 0.03% sodium dodecyl sulfate for 48 hours.Results of hematoxylin and eosin staining,light microscope and scanning electron microscope showed that,the main components of extracellular matrix (collagen fiber) were reserved.There was no significant difference in the morphological structure and the intensity of collagenous scaffolds before and after decellalarization (P＞0.05).There was no apparent reject reaction at the embedded site,local incisions healed well.New vessels could be observed in the scaffolds two weeks later.There was no significant difference in the intensity of collagenons scaffolds before and after inoculation (P＞0.05).CONCLUSION:The low osmotic Tris buffer containing 0.03% sodium dodecyl sulfate is suitable for decellularizing the vein.The homograft collagenous scaffolds exhibit no rejection after transplantation,and the intensity of the scaffolds does not descend.VEGF and bFGF can improve the growth of new vessels in the decellularized scaffolds,and have a synergistic effect.

BACKGROUND: An important development orientation of osteomyelitis treating is to prepare a drug delivery system which has the characteristics of excellent biocompatibility, degradable, lengthen drug-released time, source sufficient, as well as use security. Alginate and chitosan can be used as drug delivery system due to the superordlnary biological properties. OBJECTIVE: To explore the feasibility and safety of alginate/chitosan incorporated vancomycin (VCM/ACA) as release carrier, in addition, to compare the difference from systematic injection. DESIGN, TIME AND SETTING: An in vivo drug concentration determination, matching grouping experiment. The experiment was performed at the animal and orthopedics laboratories, Affiliated Zhongshan Hospital of Dalian University from August 2008 to March 2009. MATERIALS: The alginate solution and vancocin solution was uniform mixed followed by adding CaCO_3 and citrate sodium solution, then the mixed liquor was prepared for vancocin-calcium alginate gel beads with microcapsule preparation instrument. After that, the vancocin-calcium alginate gel beads were reacted with chitosan/vancocin mixed liquor and cellulose acetate to prepare for VCM/ACA release carrier. METHODS: Forty rabbits were prepared for middle of left femur bone defect models, and then randomized divided into 2 groups, with 20 animals in each group. In the local medication group, VCM/ACA release carrier was inlaid to the defects. In the systemic administration group, rabbits were intravenous injected 10% vancocin (10 mg/kg). MAIN OUTCOME MEASURES: The drug concentrations in the serum and bone tissues of the local medication group was detected by high performance liquid chromatograph at hours 0.5, 1, 6, 24, 72 and weeks 1, 2 after operation. In the systemic administration group, the drug concentrations in the serum, bone and muscle tissues were measured at minute 10 and hours 0.5, 1, 6, 24, and 72 after operation. In addition, histological sections of body tissues were prepared to look for signs of systemic toxicity of the implants. RESULTS: The serum drug concentrations of the systemic administration group were obvious greater than the local medication group at each time points prior to 24 hours, which less than the local medication group at hour 24. The drug concentration in bone and muscle tissues of local medication group were significant greater than the systemic administration group at different time points, which sustained for at least 2 weeks, while serum concentration in the systemic administration group was much lower than minimum inhibitory concentration after 24 hours. However, no multiple tissues revealed histological evidence of toxicity. CONCLUSION: There has feasibility and safety in vivo in course of ALM/VCM release carrier, which has superior effect to systemic administration.

Objective To retrospectively analyze the surgical methods and efficacy in 70 cases of type A aortic dissection patients over 65 years old.Methods From January 2005 to May 2012,70 type A aortic dissection patients over 65 years old received surgical treatment.Among them,there were 47 males aged 65 to 78 years old with mean 71,23 females,aged 65 to 72 years old with mean 68.55 cases were acute onset,while 15 cases were chronically onset.Different surgical methods were selected depend on patients' situations.We followed up all patients after discharged from hospital to continue to observe their health situation and evaluate the therapeutic effects.Results After surgery,eight patients died in the hospital,62 patients were recovered and discharged from the hospital.The mortality rate is 11.4％.During the follow up period from 3 to 72 months,there were no dead,aneurysm rupture and others severe complications.9 cases received endovascular graft exclusion within 6 months after discharged from hospital.The survival patients were satisfactory healed with their daily living activity resumed.Conclusion For over 65 years old patients with aortic dissection,the accurate and rapid selection of surgical method could improve the survival rate and the quality of life with a lower occurrence rate of complications.

Ocular choristoma is composed of ectopic tissues with normal structures. The pathogenesis still remains uncertain. Histopathologically, it is a dense connective tissue mixed with epidermal appendages, smooth muscle cells, mature adipose tissue, lacrimal glands, lymph nodes, skeletal muscle fibers, cartilage and bone. Because of its low incidence, most of published literature are case reports. The clinical manifestations are non-specific and we need to distinguish it from other ocular masses. The choice of surgical resection depends on the ocular symptoms, the effect on appearance, and the need for clinical confirmation. This paper reviews the epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis and treatment of ocular choristoma.

Silibinin exhibits antidiabetic potential by preserving the mass and function of pancreatic β-cells through up-regulation of estrogen receptor-α (ERα) expression. However, the underlying protective mechanism of silibinin in pancreatic β-cells is still unclear. In the current study, we sought to determine whether ERα acts as the target of silibinin for the modulation of antioxidative response in pancreatic β-cells under high glucose and high fat conditions. Our in vivo study revealed that a 4-week oral administration of silibinin (100 mg/kg/day) decreased fasting blood glucose with a concurrent increase in levels of serum insulin in high-fat diet/streptozotocin-induced type 2 diabetic rats. Moreover, expression of ERα, NF-E2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) in pancreatic β-cells in pancreatic islets was increased by silibinin treatment. Accordingly, silibinin (10 μM) elevated viability, insulin biosynthesis, and insulin secretion of high glucose/palmitate-treated INS-1 cells accompanied by increased expression of ERα, Nrf2, and HO-1 as well as decreased reactive oxygen species production in vitro. Treatment using an ERα antagonist (MPP) in INS-1 cells or silencing ERα expression in INS-1 and NIT-1 cells with siRNA abolished the protective effects of silibinin. Our study suggests that silibinin activates the Nrf2-antioxidative pathways in pancreatic β-cells through regulation of ERα expression.

Objective: To investigate fast food consumption behaviors among 4th and 5th grade primary school students in agricultural and pastoral areas in Qinghai Province, and to provide scientific basis for nutrition education and intervention measures for school age children in agricultural and pastoral areas. Methods: Using multi stage stratified cluster random sampling method, a total of 969 fourth and fifth grade students were selected from 10 primary schools in 4 counties and districts in 3 cities of Haidong City, Hainan Prefecture and Haixi Prefecture from Qinghai Province. Self administered questionnaires were used to investigate the fast food consumption behaviors of participants. Results: The proportions of senior primary school students in agricultural and pastoral areas of Qinghai Province who had consumed western fast food and traditioal fast food in the past week were 45.8% and 75.6%, respectively, with statistically significant differences ( χ 2=290.24, P <0.05). The times of traditional fast food consumption in the past week among boarding students were higher than that of non boarding students( Z =6.44,5.84, P <0.05). The main reasons for senior primary school students in agricultural and pastoral areas of Qinghai Province to choose to consume western fast food were that it was delicious (84.7%), nutritious (62.6%), clean and hygienic (57.4%), and a better environment (57.0%). The top 4 reasons for chousing Chinese fast food were yummy(83.8%),nutritious(82.8%),clean and healthy(67.4%),and good environment(53.5%). Among the surveyed primary school students, 64.7% believed that diet structure of Chinese fast food was reasonable, 43.0% believed that the nutritional value of Chinese fast food was high, and 39.4% believed that the energy content of western fast food was high. Conclusion Fast food consumption is a common dietary behavior of senior primary school students in agricultural and pastoral areas of Qinghai Province. Relevant departments should strengthen the nutrition education related to fast food, promote the dissemination of health knowledge, enable students to develop a good lifestyle and reduce fast food consumption.