Objective To investigate the anterior trans-injured vertebral short segment limited fixation and fusion in treating thoracic and lumbar spinal tuberculosis.Methods One hundred and three patients with spinal tuberculosis from 2010 to 2012 were operated by trans-anterior approach(trans-thoracic above thoracic spine 12,trans-retroperitoneal below waist spine 1)tuberculosis focus clearance and spinal canal decompression,intervertebral bone graft of vertebral structure,and short segment internal fixation for residual disease spine.Results The nerve function of the patients was effectively improved after surgery,and the imaging re-sults showed that the average lesion kyphosis angle was significantly decreased(P <0.05).The postoperative follow-up found that the bone graft was fused after half a year,and the average local kyphosis angle was still 13°,which had no obvious change compared with that after operation.In addition,the internal fixation position had no looseness and fracture,the grafted bone had no displace-ment and detachment,the four limbs movement was normal without local percussion pain or tenderness.Conclusion The anterior trans-injured vertebral short segment limited fixation and fusion has the satisfactory short term clinical efficacy in the treatment of thoracic and lumbar spinal tuberculosis.

Objective To understand the actual situation of community‐based diabetes management and analyze common prob‐lems in diabetes management and find the solutions to diabetes management though the objective investigation .Methods The pa‐tient′s data including gender ,age ,education ,medication ,lifestyle information were collected by household face‐to‐face survey and were performed a single factor χ2 analysis of relevant indicators .Results Relative to the patients with middle school education only and is less than 3 000 a month ,the diabetic patients who ere above the junior middle school and family income equal to or greater than 3 000 had good diabetes management on medication ,diet ,exercise ,blood glucose monitoring ,diabetes related knowledge .Con‐clusion Patient′s education and economic level could effect attitudes toward diabetes ,medication ,diet ,exercise ,blood glucose moni‐toring ,diabetes‐related knowledge .

BACKGROUND:Carboxymethyl chitosan (CMCS),a chitin derivative,has a good application performance that makes it become a safe and effective hemostatic material.OBJECTIVE:To determine the hemostatic effect of CMCS and its biosecurity properties.METHODS:(1) CMCS powder was scattered on the caudal vein and liver wounds of Sprague-Dawley rats,and the hemostatic time was recorded as experimental group,while the time for natural haemostasis of the wound was recorded as control group.(2) CMCS powder was scattered on the tail,femoral artery and liver wounds of ICR mice,and the hemostatic time was recorded as experimental group,while the time for natural haemostasis of the wound was recorded as control group.(3) CMCS,Sodium dodecyl sulfate solution and distilled water were respectively applied on the skin of albino rabbits in a skin irritation test.(4) A delayed-type hypersensitivity test of CMCS was carried out by intradermal injection of CMCS in guinea pigs.(5) An intradermal irritation test was carried out by subcutaneous injection of normal saline containing CMCS and normal saline,respectively.Another intradermal irritation test was carried out by subcutaneous injection of the supernatant of CMCS olive oil extract and olive oil,respectively.RESULTS AND CONCLUSION:(1) Compared with the control group,the hemostatic time for caudal vein and liver wounds were significantly shortened in the Sprague-Dawley rats in the experimental group (P ＜ 0.01).(2) Compared with the control group,the time of hemostasis on the tail,femoral artery and liver wounds was significantly shortened in the ICR mice in the experimental group (P ＜ 0.05 or P ＜ 0.01).(3) The CMCS had no irritation to the skin of albino rabbits and no allergic reaction to the skin of guinea pigs.To conclude,the CMCS has good hemostatic effect on the wound in Sprague-Dawley rats and ICR mice,and has no skin irritation,allergic reactions and intradermal irritation reactions in albino rabbits and guinea pigs,which is a relatively safe hemostatic material.

[Objective] The study was conducted to investigate the effect of micronized fenofibrate on acute insulin response in the subjects with impaired glucose metabolism and hypertriglyceridemia. [Methods] Fifty-three subjects were randomly (2:1 ratio) allocated to fenofibrate group (n=36, including IFG 3 cases, IGT 19 cases, IFG/IGT 6 cases, T2DM 8 cases) or control group (n = 17, including IFG 1 case, IGT 9 cases, IFG/IGT 4 cases, T2DM 3 cases) without any intervention for 3 months. Fasting blood samples were collected for measuring fasting plasma glucose (FPG), free fatty acids (FFA), and lipid profile. IVGTTs were carried out with measurement of plasma insulin before and after treatment. Acute insulin response (AIR), the maximum insulin concentrations (C_(INS,MAX)) to fasting insulin (FINS) ratio (C_(INS,MAX)/FINS) and values of the maximum insulin concentrations increment (△C_(INS)) during IVGTT were calculated as indexes of first-phase insulin secretion. HOMA insulin resistance index (HOMA IR) was used for assessing insulin resistance. [Results] After 3-month treatment, the lipid profile was evidently improved in fenofibrate group. Levels of trigiyceridemia (TG), low-density lipoprotein cholesterol and FFA were significantly reduced and high-density lipoprotein cholesterol increased significantly. Waist circumference was also significantly declined. No change of above indicators was found in control group. In fenofibrate group, C_(INS,MAX)/FINS and △C_(INS) were significantly increased (median 8.4 pmol/L vs. 5.3 pmol/L, 808±473 pmol/L vs. 660±472 pmol/L, both P<0.0001), along with great improvement of AIR (5 585±3 441 pmol·L~(-1)·min~(-1) vs. 4 444±3 642 pmol·L~(-1)·min~(-1), P<0.0001). The level of FINS and HOMA IR was also markedly reduced (108±65 pmol/L vs. 166±115 pmol/L, P = 0.002; 3.8±2.3 vs. 6.0±4.2, P = 0.001). In contrast, there were modest declining in acute insulin response (AIR: 4 313～1 943 pmol·L~(-1)·min~(-1) vs. 5 362±2 861 pmol·L~(-1).min~(-1); C_(INS,MAX)/FINS: median 4.6 vs. 7.0, P= 0.01; △C_(INS): 641±286 pmol/L, vs. 720±321 pmol/L, P= 0.003 9) and increasing HOMA IR (7.8±4.2 vs. 5.6±3.2, P<0.000 1) in control group after 3-month follow-up. The improvement of AIR was correlated with the decreasing of plasma FFA and TG (r=0.41, 0.36, P = 0.002, 0.014), but no correlation with the changing of FPG and HOMA IR. [Conclusions] These results indicated that sbort-term lipid-lowering treatment with fenofibrate evidently improved acute insulin response and alleviated insulin resistance in subjects with impaired glucose metabolism and hypertriglyceridemia. Moreover, the improvement of insulin secretion capacity may be mainly due to the relieving of iipotoxity resulting from finofibrate.

Thirty six patients with hypertriglyceridemia and impaired glucose regulation or newly diagnosed type 2 diabetes, whose fasting plasma glucose was ≤8.0 mmol/L, were treated by fenofibrate for 3 months. Lipid profile, insulin during intravenous glucose tolerance test and oral glucose tolerance test ( including glucose) were measured before and after treatment After treatment, lipid profile was significantly improved. Insulinogenic index (△I30/△G30) and acute insulin response were significantly increased (98. 9vs. 129. 2, 3558.9 vs. 4783. 3 pmol · L - 1 · min - 1, respectively, P ＜ 0. 05 ). Fasting insulin and insulin resistant index in homeostasis model assessment ( HOMA IR) decreased ( 128. 6 vs. 84. 8 pmol/L, 4. 8 vs.3.0, respectively, P ＜0. 05 ). The improvement of insulin secretory function was more significant in patients with higher triglyceride (TG ＞ 3. 3 mmol/L). These results indicate that short-term lipid-lowering treatment with fenofibrate can improve β-cell function and insulin resistance. Patients with higher triglyceride are likely to achieve more benefit from lipid-lowering treatment.

Objective To investigate the functions of microRNA-1 43 (miR-1 43)in esophageal cancer cell line ECA1 09.Methods ECA1 09 cells were transfected with negative control (NC),miR-1 43 mimics or miR-1 43 inhibitors.3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT)assay was per-formed to evaluate the growth of ECA1 09 cells after transfection.Annexin V-FITC /PI apoptosis test kit was used to detect early apoptosis rate in ECA1 09 cells.Transwell migration and invasion assays were conducted to compare the migration and invasion capacity of ECA1 09 among different groups.Real-time PCR and Western blotting were used to analyze the mRNA and protein alteration after transfection.Results Three and four days after transfection,compared with NC (absorbance value:0.90 ±0.02 and 1 .09 ±0.07),miR-1 43 mimics inhibited ECA1 09 cell proliferation (absorbance value:0.66 ±0.05 and 0.80 ±0.04),while miR-1 43 inhibi-tors promoted cell proliferation (absorbance value:1 .1 3 ±0.09 and 1 .51 ±0.08),with statistical signifi-cances (F =49.1 6,P =0.000;F =1 00.34,P =0.000).Early-stage apoptosis rates of ECA1 09 transfected with NC,miR-1 43 mimics and miR-1 43 inhibitors were 3.42% ±0.72%,1 1 .63% ±1 .1 5% and 0.94% ± 0.1 0%,respectively,with statistical significance (F =1 51 .61 ,P =0.000).Meanwhile,compared with NC (migration cell number:336 ±1 3,invasion cell number:1 47 ±1 6),miR-1 43 mimics inhibited cell migration (1 48 ±1 6)and invasion (75 ±1 0),while miR-1 43 inhibitors promoted cell migration (51 0 ±1 4)and inva-sion (238 ±1 6),with statistical significances (F =470.99,P =0.000;F =90.04,P =0.000).Compared with NC (1 .00 ±0.00),miR-1 43 mimics down-regulated mRNA (relative expression level 0.22 ±0.08)and protein expression (relative expression level 0.46 ±0.08)of K-ras,whereas miR-1 43 inhibitors up-regulated mRNA (1 .55 ±0.1 2)and protein expression (1 .33 ±0.05)of K-ras (F =1 31 .36,P =0.000;F =88.1 7, P =0.000).Conclusion miR-1 43 functions as a tumor suppressor in esophageal cancer cell line ECA1 09, probably by down-regulating K-ras expression.

Insulin secretion and insulin resistance were evaluated in 152 subjects with normal glucose tolerance, impaired fasting glucose (IFG) and (or) impaired glucose tolerance (IGT). The data showed that subjects with IGT exhibited an evident deficit in the early and late phases of insulin secretion after glucose load and mild insulin resistance, and subjects with IFG demostrated evident insulin resistant and a great decline in early phase insulin response and HOMA-β.

Faciliysyion techniques were used to help improve the extremity motor functions of 43 elderly and 79 middle aged or youthful stroke patients. The Fugl-Meyer scale was employed for thc assessment of the functional status. The results showed that the motor function of upper extremty of thc elderly patients was not improved. but the motor function of lower extremity was improved significantly. The motor functions of upper and lower extremities were all improved significantly in the middle-aged or youthful patients. In early rehabilitation group the Increased motor function marks of the upper extremity of the elderly stroke patients were less than that of the middle-aged or youthful stroke patients. the increased motor function marks of the lower extremity of The elderly stroke patients were less significantly than that of the middle-aged or youthful stroke patients also. In late rehahilitation group the increased motor function marks of the lower extremity in elderly stroke patients were more than that in the middle-aged or youthful stroke patients.

ObjectiveFrom the changes of expression of cold-inducible RNA-binding protein (CIRP) in rats with traumatic brain injury under mild hypothermia treatment with Shenfu decoction as a subsidiary, to speculate the mechanism of protective effect of the decoction on the injury.Methods Ninety Sprague-Dawley (SD) rats were divided into three groups by random number table: non-transfection control group, adenovirus mediated immune flourescent reverse transcription virus group (blank AD5-GFP transfection group) and adenovirus mediated immune flourescent reverse transcription virus carrying CIRP silent expression gene group (AD5-GFP-CIRP-SiRNA transfection group), 30 rats in each groups. Then, each group was subdivided into three subgroups: model group, traditional Chinese medicine (TCM) low and high dose groups, 10 rats in each subgroup. After the mild hypothermia treatment for 48 hours, in the TCM low dose group and high dose group, a dose of TCM 1 mL/kg and 5 mL/kg was injected via a tail vein into the rat respectively, while in the model group, 1 mL/kg normal saline was injected into the same vein, once a day for consecutive 2 days in all the groups. Before modeling in the blank AD5-GFP transfection group and AD5-GFP-CIRP-SiRNA transfection group, virus transfection models were reproduced at first by one-time intrathecal injection of 0.1 mL AD5-GFP and 0.1 mL (1×1010 pfu/mL) AD5-GFP-CIRP-SiRNA virus vector respectively, and in model group, 0.1 mL normal saline was given. The rat cortex, hippocampus and hypothalamus part were collected, the brain cell apoptosis was detected by transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL), the CIRP mRNA expression in the cortex, hippocampus and hypothalamus part was measured by reverse transcription-polymerase chain reaction (RT-PCR), the protein expressions of rat sarcoma protein Raf, Ras, extracellular signal-regulated kinase (ERK), phosphorylation ERK (p-ERK), mitogen activated protein kinase (MEK), p-MEK were determined by Western Blot.Results The brain tissue cell apoptosis indexes (AI) in the cortex, hippocampus and hypothalamus part in TCM low, high dose group of non-transfection control and blank AD5-GFP transfection group were lower than those in model group, and the expressions of CIRP mRNA were higher than those in model group, there were no significant differences in AI and CIRP mRNA in the cortex, hippocampus and hypothalamus between model, TCM low and high dose groups of AD5-GFP-CIRP-SiRNA transfection group, but AI was significantly higher and CIRP mRNA was significantly lower than that in corresponding subgroups of AD5-GFP transfection control group and blank AD5-GFP transfection group. Western Blot detection showed that: Raf/Ras, p-MEK/MEK protein expressions revealed no statistical significant differences in different parts of each group (allP > 0.05), the p-ERK/ERK protein expression in the cortex, hippocampus, and hypothalamus part was significantly lower in TCM low and high dose group than that in the model group of non-transfection control group and blank AD5-GFP transfection group, the degree of descent in the TCM high dose group being more significant (the cortex: non-transfection control group was 7.2±1.0 vs. 15.3±1.8, AD5-GFP transfection group was 8.1±0.7 vs. 16.2±1.5; hippocampus part: non-transfection control group was 6.6±0.8 vs. 14.7±2.0, AD5-GFP transfection group was 6.8±1.0 vs. 14.9±1.3; hypothalamus part: non-transfection control group was 9.4±1.1 vs. 12.7±1.7, AD5-GFP transfection group was 10.6±1.3 vs. 9.4±1.1, allP < 0.05). There were no significant statistical differences in p-ERK/ERK protein expression in above brain parts between AD5-GFP-CIRP-SiRNA transfection subgroups (allP > 0.05).Conclusions The Shenfu decoction used in rats with brain trauma under treatment of mild hypothermia is possibly by promoting CIRP over-expression, lowering ERK expression and inhibiting the initiation of signal transduction of the secondary transcription factor phosphorylation, thereby the neural cell apoptosis is decreased and play a subsidiary role of anti-apoptosis of mild hypothermia.

One hundred and forty-five patients with primary aldosteronism (PA) admitted from 2006 to 2013 were enrolled in the study. The diagnosis of PA was confirmed by upright furosemide test and all patients met the following criteria: ① round-or oval-shaped lesion of low density with diameter>1 cm in one adrenal gland shown in contrast CT scan; ② no lesion or abnormality in contralateral adrenal gland; ③serum potassium level<3.5 mmol/L. Of 145 patients, 106 underwent total adrenalectomy, 36 partial adrenalectomy and 3 tumor enucleation. Serum potassium was (2.75±0.55) mmol/L before and (4.03±0.46) after surgery. Potassium was normalized after treatment in 141 cases (97.2％) with correction or improvement in hypertension; 4 patients (2.8％) remained hypokalemic and received spironolactone. Patients with normalized potassium were followed up for a medium period of 74 months (22—103 months), of whom 32 (22.7％) dropped off; the remaining 109 (77.3％) patients did not have hypokalemia. Multivariate linear correlation analysis showed that serum potassium level was negatively correlated with tumor diameter (r=?0.273,95％ CI:?0.086—?0.564, P=0.026) and basal serum aldosterone level (r=?0.261,95％ CI:?0.047— ?0.514, P=0.036). In PA patients with unilateral adrenal macroadenoma and hypokalemia, satisfactory surgical resolution can be achieved without adrenal venous sampling in majority of patients.