Objective To explore the relation between serum nesfatin-1 ,tumor necrosis factor (TNF)-αand insulin resistance. Methods A total of 105 subjects were enrolled in this study and divided into two groups:patients with newly diagnosed type 2 diabetes mellitus (T2DM group,n= 64)and normal controls (NC group,n= 41). The fasting serum nesfatin-1 and TNF-αlevels were measured by enzyme-linked immuno sorbent assay (ELISA). FPG,HbA1 c,TG,TC,and FIns were also tested. BMI, HOMA-IR,HOMA-β,and ISI were calculated. Results Serum nesfatin-1 and TNF-αlevels were significantly higher in T2DM group than in NC group. Multiple linear regression analysis showed that the most significant influencing factors for nesfatin-1 were TNF-αand ISI(β= 0. 005、-6. 847,P<0. 05). The most significant influencing factors for TNF-αwas HbA1 c (β= 26. 652,P<0. 01). Conclusion Serum nesfatin-1 and TNF-αare significantly elevated in patients with newly diagnosed T2DM,which may influence the glucolipid metabolism through the signal pathway of insulin and play a role in the pathogenesis of T2DM and IR.

Objective To explore the prevalence of multilevel lumbar spondylolysis in operation patients,and to evaluate the diagnostic value of CT reconstruction on multilevel lumbar spondylolysis.Methods A total of 312 patients,who had undergone surgical treatment in our hospital from January 2004 to March 2012 for lumbar spondylolysis,were enrolled in this study.There were 147 males (47％) and 165 females (53％),aged from 12 to 76 years (average,44 years).Every patient underwent lumbar spine X-ray examination including anteroposterior,lateral,over-flexion,over-extension and double oblique X-rays,as well as CT examination.The prevalence of multilevel lumbar spondylolysis in all operation patients and the involved segments were recorded and analyzed.Moreover,the clinical manifestation and radiological features were summarized.Results In all enrolled patients,there were 9 patients (2.9％) with multilevel lumbar spondylolysis,including 5 males and 4 females,aged from 21 to 51 years (average,39 years).As for lesion distribution,there were 8 cases of bilateral spondylolysis located at both L4 and L5,and 1 case of bilateral spondylolysis at L5 combined with right spondylolysis of L4 and discontinuity in the base of left pedicle of L4.Among 9 patients,only 3 patients obtained correct diagnosis by anteroposterior and double oblique X-rays of the lumbar spine,while all patients got final diagnosis by sagittal and oblique coronal reconstruction of lumbar spine CT scan.The oblique coronal CT reconstruction could show the details of bone defect in lumbar vertebral isthmus,bony callus,peripheral osteophytes,as well as fibroplasia.For unilateral lumbar spondylolysis,the oblique coronal CT reconstruction could also show the reactive sclerosis in contralateral lamina of vertebra.Conclusion Multilevel lumbar spondylolysis is not rare in operation patients,and L4 and L5 are most common involved levels.Sagittal and oblique coronal reconstruction of lumbar spine CT scan is more accurate in showing the details of lumbar spondylolysis,which is helpful in decreasing the missed diagnosis and improving therapy.

Objective To discuss the efficacy and safety of sodium tanshinone ⅡA combined with edaravone in treatment of acute cerebral infarction.Methods 100 cases of acute cerebral infarction were randomly divided into two groups.The control group (50 cases) was treated with edaravone.The observation group (50 cases) was treated with sodium tanshinone ⅡA combined with edaravone.The efficacy of sodium tanshinone ⅡA combined with edaravone in treatment of acute cerebral infarction was evaluated by the efficacy at 1 month after treatment,ESS scores,SF-36 scores before and after treatment and adverse reaction during treatment.Results After treatment,the effective rate of observation group was 90.0％ and control group was 72.0％.The effective rate of observation group was higher than that of the control group (P ＜ 0.05).Compared with the value before treatment,the ESS scores of two groups were increased after treatment (P ＜ 0.05).3 d,7 d,14 d after treatment,the ESS scores of observation group was higher than that of the control group (P ＜ 0.05).Before treatment,there were no statistical significance on SF-36 between two groups.After treatment,the SF-36 scores were increased in two groups (P ＜ 0.05).During treatment,there were no statistical significance on adverse reaction between two groups.Conclusion Sodium tanshinone ⅡA combined with edaravone had a good therapeutic effect on acute cerebral infarction.It could improve the quality of life and neurological function with high safety.It was worthy of clinical application.

Objective To study the effect of chronic iodine supplement on thyroid of iodine-deficient rats.Methods Iodine-deficient rat models were made by giving 4- week-old rats iodine-deficient fodder for 3 months.These iodine-deficient rats were then supplemented for 8 months 1-,3- and 6- fold iodine which corresponded to the 3 levels of iodine intake found in our epidemiological study in 3 rural communities.Then changes of thyroid after iodine supplement were observed.Results After supplement of 1-,3- and 6- fold iodine to iodine-deficient rats for 8 months,thyroid relative weight did not recover,and iodine accumulated in thyroid.The ultrastructure injuries of swelling mitochondria and dilating endoplasmic reticulum in epithelial cells of iodine-deficient thyroid did not recover,but became worse with iodine supplement increase.Conclusion Iodine supplement alone can not correct the injuries resulting from iodine deficiency;moreover,a sub-pathological state might occur.

Objective To investigate the mechanism of 5′adenosine monophosphate-activated pro-tein kinase ( AMPK) in the regulation of LPS-induced secretion of inflammatory cytokines in mouse alveolar macrophages.Methods Alveolar macrophages were isolated from wild type and AMPKα1-/-C57BL/6J mice.ELISA was used to measure the concentrations of IL-1βand TNF-αin the culture supernatants of LPS treated alveolar macrophages with or without 5-amino-1-β-D-ribofuranosyl-imidazole-4-carboxamide ( AICAR ) stimulation.Western blot assay was performed to analyze the expression of AMPKα1 and AMPKα2 in alveolar macrophages isolated from wild type and AMPKα1-/-mice as well as the LPS-induced changes of p-AMPKαactivity in wild type mice.Results The LPS-induced secretion of inflammatory cyto-kines in alveolar macrophages isolated from AMPKα1-/-mice were significantly higher than that of wild type mice.The activities of p-AMPKαin wild type mice were suppressed by LPS treatment.Treatment of AICAR inhibited the LPS-induced secretion of TNF-αand IL-1β.Conclusion The LPS-induced secretion of in-flammatory cytokines was enhanced in AMPKα1-deficient mice, but could be suppressed upon the treatment of AICAR, an agonist of AMPK.AMPK was involved in the regulation of LPS-induced secretion of inflamma-tory cytokines by alveolar macrophages in mice.

OBJECTIVE: To determine the protective effects of nourishing spleen yin recipe (Zibu Piyin Recipe, ZBPYR), a compound traditional Chinese herbal medicine, on endoplasmic reticulum (ER) in neuronal cells responding to the stress by using sero-pharmacological method. METHODS: The mouse neuroblastoma cell line Neuro2a cells were treated with tunicamycin (Tm, an inhibitor of N-glycosylation). The ZBPYR-treated cell group was established by incubating cells with ZBPYR serum for one hour and treated with Tm. Reverse transcriptase PCR (RT-PCR) was utilized to detect the mRNA expressions from two genes after treatments, ER molecular chaperone glucose regulated protein 78 (GRP78) and transcriptional factor CCAAT/ enhancer-binding protein-homologous protein (CHOP). Lactate dehydrogenase (LDH) assay was also carried out to determine the LDH leakage from Neuro2a cells after treated with Tm and staurosporine (STS). RESULTS: The ZBPYR-treated cell group at all tested ZBPYR dosages showed significantly reduced expressions of both genes compared with Tm (5 microg/ml) treated control group (P<0.05). Therefore, ZBPYR serum inhibited the expressions of GRP78 and CHOP in mRNA level under ER stress induced by Tm. Different concentrations of ZBPYR serum pretreatment reduced the LDH leakage compared with the Tm and STS groups (P<0.05). Therefore, ZBPYR serum may inhibit the LDH leakage induced by Tm and STS. CONCLUSION: ZBPYR has neuroprotective effects. The mechanisms may be associated with inhibition of ER stress and mitochondrial dysfunction.

This paper reviews the computer vision and image analysis studies aiming at automated diagnosis or screening of malaria in microscope images of thin blood film smears. On the basis of introducing the background and significance of automatic detection technology,the existing detection technologies are summarized and divided into several steps,including image acqui-sition,pre-processing,morphological analysis,segmentation,count,and pattern classification components. Then,the princi-ples and implementation methods of each step are given in detail. In addition,the promotion and application in automatic detec-tion technology of thick blood film smears are put forwarded as questions worthy of study,and a perspective of the future work for realization of automated microscopy diagnosis of malaria is provided.

Objective To evaluate the MR imaging features of chondrnblastoma. Methods MRI examinations of 20 patients with histological proven chondroblastoma were reviewed retrospectively. The MRI findings of chondroblastoma including the signal intensity, the shape, the growth patterns, and the surrounding bone marrow edema and the adjacent soft tissue edema, the periosteal reaction, the adjacent joint effusion were analyzed . Results All 20 cases demonstrated heterogeneous MR signal intensity on T1WI and T2WI images and showed Iobular margins. Sixteen cases demonstrated expansive growth patterns. Surrounding bone marrow edema was found in 18 cases and adjacent soft tissue edema in 14 cases. Periosteal reaction was identified in 6 cases. In 7 cases the tumor extended to adjacent soft tissue. Adjacent joint effusion was visible on MRI in 6 cases. Conclusion Heterogeneous signal intensity, lobular margins and expansive growth pattern, adjacent bone marrow and soft tissue edema were the common features of chondroblastoma on MRI.

BACKGROUND: After acute spinal cord injury (SCI), edema of spinal cord is an important factor for inducing and deteriorating pathological changes of spinal cord tissue. After injury, noradrenaline (NE) instantly causes microvascular contraction, endothelial injury, increase of arterial permeability and participation in edema. Recently, many researches suggest that excitatory amino acids (EAA) are related to cellular edema.OBJECTIVE: To study the effect and mechanism of selective phenol aminergic neuron, 6-hydroxy dopamine (6-OHNA)and aspartic acid (ASP) on edema after acute SCI.DESIGN: Randomized controlled study.SETTING: Department of Spine Surgery, the Third Hospital of Hebei Medical University.MATERIALS: The experiment was carried out at the Experimental Animal Center of the Third Hospital of Hebei Medical University from March to September 2003. A total of 160 Wistar rats weighing 300-350 g of both genders were randomly divided into three groups: 6-OHNA group (n =60), MK-801 group (n =50) and control group (n =50).METHODS: Acute SCI was induced at the level of T13 vertebral body with the static lcad technique. Rats in 6-OHNA group were injected with 6-OHNA into subarachnoid space; rats in MK-801 group were injected with MK-801 into caudal vein; rats in control group did not receive any treatment. The extent of edema was compared in the three groups by means of neurological scoring, water content measurement, light microscopy and electron microscopy.MAIN OUTCOME MEASURES: Neurological scores and water content.RESULTS: All 160 rats were involved in the final analysis. ① After SCl, content of NE in 6-OHNA group was decreased from (217.45±4.26) ng/g to (29.37±2.61) ng/g, and the difference was significant (P＜ 0.01). Edema in spinal cord tissue was effectively inhibited for 24 hours. At 12 hours after SCl, function recovered remarkably and vascular-derived edema was the mildest. ② In MK-801 group, there was no significant suppression of the edema until 24 hours after injury. Early recovery of neurological function was not significantly different from that in control group (P ＞ 0.05), but functional recovery was obvious until 24 hours after injury (P＜0.05). The degree of cytotoxic edema was the lightest.CONCLUSTON: NE can inhibit vascular-derived edema at early phase of SCI, and EAA can inhibit cytotoxic edemas,which develops at a relatively later stage.

Objective To investigate the effect of sodium citrate on the efficacy of oral midazolam premedication in children with congenital heart disease. Methods Forty ASA Ⅱ or Ⅲ children, aged 2-6 yr, weighing 12-20 kg, undergoing cardiac surgery, were randomly divided into 2 groups (n = 20 each): control group (gronp C) and sodium citrate group (group S). Group S received oral mixture of midazolam 0.12 ml/kg (0.6 my/kg), ketamine 0.12 ml/kg (6 my/kg), glucose 0.12 ml/kg (60 mg/kg) and sodium citrate 0.12 ml/kg (3 mg/kg), total volume 0.48 ml/kg. Group C received oral mixture of midazolam 0.12 ml/kg, ketamine 0.12 ml/kg and glucose 0.24 ml/kg, total volume 0.48 ml/kg. Hydrochloric acid (pH value 1.75) was mixed with the mixtures in the two groups and pH values were measured. Preoperative anxiety scale and the onset time,sedation score and parental separation score after receiving oral drugs were recorded in preparation room for anesthesia. After entering the operating room, HR, MAP and SpO2 were monitored, and the response to venepuncture in children and the adverse effects associated with oral drugs were also observed and recorded. Results The pH value was 1.97 in group C and 4.52 in group S. The parental separation score, sedation score and response score were significantly lower and the onset time was significantly shorter in group S than in group C. HR, MAP and SpO2 were in the normal range after entering the operating room. There was no obvious adverse effect after administration of oral drugs in the two groups. Conclusion Application of sodium citrate in the oral premedication in children with congenital heart disease can raise the pH value, shorten the onset time of midazolam, and enhance the sedative efficacy.