Objective To explore the effects of insulin pump on pancreatic ?-cells in type 2 diabetes mellitus accompanied with hyperglycaemia.Methods We treated 46 cases of newly diagnosed type 2 diabetes mellitus with fasting blood glucose≥10.0 mmol/L by insulin pump for 2 weeks.Their blood sugar and insulin were determined before and after treatment by oral glucose tolerance test and insulin releasing test.We then calculated the function index,morning secretion of pancreatic ?-cells and insulin resistance index.The patients were followed up for 6 months and the blood glucose was monitored.Results After treatment,insulin,function index and the morning secretion were increased significantly,while the blood sugar and resistance index were decreased.In all the patients,16 could maintain ideal blood glucose only by alimentary control and exercise.Conclusion With the insulin pump in a short term,patients with type 2 diabetes mellitus can rapidly control blood glucose,obviously improve pancreatic ?-cells,and reduce insulin resistance.

Objective To study the relationship between urinary ceruloplasmin(CP)and diabetic nephropathy. Methods Two hundred and thirty-six patients with type 2 diabetes mellitus were divided into normal albuminuria group(DMN group, 129 cases) and micro-albuminuria group ( DMMA group, 107 cases).Eighty-one healthy people were admitted into control group. The levels of urinary CP, serum CP, urinary albumin(Alb)and urinary creatinine(Cr)were measured. Results The median of urinary CP/Cr in DMMA group (2.55 ng/mmol) and DMN group (1.18 ng/mmol )was higher than that in control group(0.92 ng/mmol )(P<0.01 ). There was no significant difference in the levels of serum CP in each group (P>0.05 ).The urinary Alb/Cr was significantly positively correlated with urinary CP/Cr (r=0.188 ,P<0.01 )in patients with type 2 diabetes mellitus. The course of diabetes mellitus was a risk factor of urinary CP/Cr and Alb/Cr increase. Conclusions The urinary CP shows increasing tendency in accord with urinary Alb in type 2 diabetes mellitus patients. Urinary CP elevates obviously and correlates with diabetic nephropathy. Urinary CP may be used to monitor the onset, progress and therapeutic effect of diabetic nephropathy.

Objective To observe on the variance of serum IL-18 level and lymphocyte subpopulations in the patients with obese diabetic(T2DM).Methods The diabetic obese group contained 31 cases,the non-diabetic obese group contained 33 cases,healthy normal body weight group contained 23 cases,the blood glucose(FPG),insulin (FPI),blood total cholesterol(TC),triglyceride(TG),IL-18 and the cell population of lymphocyte subpopulations CD3+and CD4+、CD8+ in peripheral blood were determined,the insulin sensitivity index were calcnlated.Results Compared with the healthy normal body weight group,the blood fat,FPG,FPI,IL-18 of T2DM patients significantly increased,there were significant statistical difference(P ＜ 0.05 or P ＜ 0.01).The ISI significantly decreased(P ＜ 0.01).Compared with the non-diabetic obese group,the blood fat and IL-18 of T2DM patients significantly increased (P＜0.05).Compared with the diabetic obese group,the subpopulations cell population of CD3+、CD4+、CD8+ in the non-diabetic obese group significantly decreased,the ratio of CD4+/CD8+ significantly increased,there were significant statistical difference(P＜0.05 or P＜0.01)in the two groups comparison.Compared with the non-diabetic obese CD4+/CD8+ significantly increased(P＜0.05).Conclusion T2DM patients should prevent the hyperinsulinemia,control blood sugar,reduce insulin resistance,sustain normal lipid metabolism,boost immune function.

Objective Bronchopleural fistula (BPF) is a common but potentially lethal complication after pulmonary resection.Currently,there is still controversy over the appropriate management strategy for BPF,especially when pleural space contamination develops.The purpose of this study was to evaluate the efficacy and safety of surgical repair fistulas combined with pedicled muscle flaps coverage in patients with early BPF after pulmonary resection based on our experience with 23 cases.Methods The clinical data for 23 patients who underwent surgical repair of early BPF from January 1999 to December 2010 at our hospital were reviewed.Thirteen patients had undergone a prior pneumonectomy and 10 patients had undergone a prior lobectomy.BPF occurred from postoperative day 5 to40 (mean postoperative day 21 ).Nine patients had a contaminated pleural space.After BPF was clearly diagnosed,prompt closed pleural drainage was instituted,followed by surgical repair of BPF.Four patients underwent a direct suture repair of fistula,ten patients underwent stump revision and suture closure,seven patients underwent stump revision and bronchoplasty or carina plasty,and a pedicled muscle flap was sewn to the edges of the fistula in two patients.The stump was covered with various muscle flaps,including interostal muscle flap in five cases,latissimus dorsi muscle flap in ten cases,serratus anterior muscle flap in six cases,and erector spinae muscle flap in two cases.Postoperatively,the pleural space was routinely irrigated and drained.Results No intraoperative or early postoperative death occurred.Four patients developed severs complications,including respiratory failure in two cases,pulmonary embolism in one case,and empyema in one case.All four cases recovered well after treatment.The mean duration of hospitalization was 33 days (range 8 - 120 days ).Surgical repair of BPF was successful in 21 cases (91.3％) but failed for 2 patients..BPF recurrence developed in only one patient two years postoperatively due to stump recurrence.He died of extensive metastatic disease 2 years after BPF recurrence.Conclusion Excellent results can be achieved by early surgical repair combined with stump pedicled muscle flaps coverage in patients with BPF who can tolerate reoperation,even if they have a contaminaled pleural space.

OBJECTIVETo observe the effect of sodium valproate (VPA) on the proliferation and apoptosis of human lung carcinoma SPC-A1 cells and the underlying mechanism.

METHODSThe effect of VPA on the proliferation of SPC-A1 cells was evaluated by MTT assay and clone formation assay. Flow cytometry was used to analyze the apoptosis of the cells exposed to VPA. The changes in the expressions of Bcl-xl, Bcl-2, Mcl-1, caspase-9, and caspase-3 in the exposed cells were detected by Western blotting.

RESULTSIncubation with VPA for 48 h resulted in a significant inhibition of SPC-A1 cell proliferation, with a IC(50) of 1.8 mmol/L. VPA treatment also inhibited cell colony formation and induced obvious cell apoptosis. Exposure to 8 mmol/L VPA for 48 h caused a percentage of early apoptotic cells of 60.44%. VPA treatment at different concentrations for 48 h obviously lowered the protein levels of Bcl-xl, Bcl-2, and Mcl-1 and induced caspase-9 and caspase-3 activation in SPC-A1 cells.

CONCLUSIONVPA can inhibit the proliferation of SPC-A1 cells by triggering mitochondrion-dependent apoptosis.

Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Caspase 9 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Humans ; Myeloid Cell Leukemia Sequence 1 Protein ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Valproic Acid ; pharmacology ; bcl-X Protein ; metabolism

BACKGROUNDTo investigate the effectiveness and the surgical experience of bronchoplasty and pulmonary artery reconstruction in the treatment of central type lung cancer.

METHODSFrom January, 1996 to May, 2000, 78 patients with central type lung cancer underwent bronchoplasty and pulmoanry artery reconstruction in the treatment of central type lung cancer. According to P-TNM classification, 5 patients were in stage IIB, 69 in stage IIIA and 4 in stage IIIB. The surgical procedures included bronchoplasty and pulmonary artery reconstruction in the left lung in 53 cases, bronchoplasty and pulmonary artery reconstruction in the right lung in 25 cases. A combination of comprehensive therapy including radiotherapy and chemotherapy was carried out postoperatively. The postoperative follow-up ranged from 24 months to 78 months.

RESULTSThere was one postoperative death resulting from respiratory infection and failure (1.3%, 1/78). The postoperative complication included pulmonary infection (6.4%) and atelectasis (7.7%). The overall 1, 3 and 5-year survival rates were 81.5%, 47.6% and 33.2% respectively.

CONCLUSIONSThe results suggest that bronchoplasty and pulmonary artery reconstruction for the patients with central type lung cancer is a safe and effective surgical technique, as alternative to pneumonectomy. This method ensures more radical resection of central type lung cancer, and extends the surgery indications to patients with poor lung function and senility by reducing the ratio of pneumonectomy and improving postoperative quality of life. Therefore, it is clinically valuable.

BACKGROUNDTracheal and carinal resection and reconstruction is an important way in treatment of lung cancer invading trachea and carina. The aim of this study is to summarize the method and effect of tracheal and carinal resection and reconstruction in treatment of lung cancer.

METHODSSeventy-three patients with lung cancer who underwent tracheal and carinal resection and reconstruction were retrospectively analyzed. There were 22 cases for right pneumonectomy and carinal resection, 14 cases for right pneumonectomy and tracheobronchoplastic procedure, 12 cases for right sleeve pneumonectomy, 15 cases for tracheobronchoplastic procedure plus right upper lobectomy, 2 cases for left sleeve pneumonectomy and 8 cases for left pneumonectomy and tracheobronchoplastic procedure.

RESULTSFour cases received palliative operation. Four patients (5.48%) died in the perioperative period. The 1-, 3-and 5-year survival rate was 75.3%, 63.0% and 23.3% respectively.

CONCLUSIONSCareful preoperative assessment, skillful operation and appropriate postoperative treatment are helpful to improve the outcome of tracheal and carinal resection and reconstruction for lung cancer.

Protein self-assemblies at the micro- and nano-scale are of great interest because of their morphological diversity and good biocompatibility. High-throughput screening of protein self-assembly at different scales and morphologies using protein crystallization screening conditions is an emerging method. When using this method to screen protein self-assembly conditions, some apparently transparent droplets are often observed, in which it is not clear whether self-assembly occurs. We explored the interaction between β-lactoglobulin and the protein crystallization kit Index™ C10 and observed the presence of micro- and nano-scale protein self-assemblies in the transparent droplets. The diverse morphology of the micro- and nano-scale self-assemblies in the transparent droplets formed by mixing different initial concentrations of β-lactoglobulin and Index™ C10 was further investigated by scanning electron microscope. Self-assembly process of fluorescence-labelled β-lactoglobulin was monitored continuously by laser confocal microscope, allowing real-time observation of the liquid-liquid phase separation phenomenon and the morphology of the final self-assemblies. The internal structure of the self-assemblies was gradually ordered over time by in-situ X-ray diffraction. This indicates that the self-assembly phenomenon within transparent droplets, observed in protein self-assembly condition screening experiments, is worthy of further in-depth exploration.
Crystallization ; Lactoglobulins