ObjectiveTo measure levels of serum resistin in patients with nonalcoholic fatty liver disease (NAFLD) and explore the relationship between serum resistin and insulin resistance,and the role of serum resistin in the pathogenesis and progression of NAFLD.Methods 53 patients (including 30males and 23 females) with NAFLD and the 28 control subjects (including 16males and 12females) were enrolled in this study.The height,weight,waist circumstance,hip girth and blood pressure of all subjects were obtained by standard methods.To all the subjects,the parameters including fasting blood glucose (FBG),triglyceride ( TG),total cholesterol (TC),high-density lipoprotein cholesterol ( HDL-c ),lowdensity lipoprotein cholesterol ( LDL-c ),alanine aminotransferase ( ALT),aspartate aminotransferase (AST)and gamma glutamyl transferase (GGT) were measured.Serum resistin was measured by electrochemiluminescence immunoassay (ECLIA) and fasting serum insulin (FINS) were measured by enzymelinked immunosorbent assay (ELISA).Body mass indexes (BMI),waist hip ratio (WHR),body fat percentage ( BF％ ) were calculated with formula.Homeostasis model assessment was applied to assess the status of insulin resistance index (HOMA-IR).The relationships between serum resistin and various parameters in patients with NAFLD were observed and analyzed by statistical methods.ResultsThere were no significant differences in the number of cases,average age,compositions of sex and BF％ between the NAFLD group and the control group ( P ＞ 0.05).In the NAFLD group,systolic blood pressure ( SBP),diastolic blood pressure(DBP).The waist circumference,hip girth and BMI and WHR were higher than those of control group ( t =3.54,3.32,3.56,5.85,5.56,4.10,P =0.001).There were no significant differences on the level of TC,HDL-c,LDL-c between the NAFLD group and the control group ( P ＞0.05).In the NAFLD group,FBG,TG,AST were higher than those of control group ( P =0.001,P =0.004,P =0.001 ).The levels of serum resistin,FINS,HOMA-IR,ALT and GGT in NAFLD group were significantly higher than those of control group,and there was significant difference between two groups ( P =0.0005).There was no significant correlation between serum resistin and age,BMI,WHR,BF％,FBG,TG,TC,HDL-C,LDL-C,AST in NAFLD group ( P ＞ 0.05).The levels of serum resistin in patients with NAFLD were positively correlated with GGT,ALT,FINS,HOMA-IR ( r =0.354,0.391,0.875,0.881,P ＜0.05 or ＜0.01 ).After multiple stepwise regression analysis,the results showed that HOMA-IR was the most important factor for affecting the levels of serum resistin.The levels of serum resistin in male and female patients with NAFLD were higher than those of control group ( P ＜0.05).But no statistical difference was found between males and females in two groups ( P ＞ 0.05).ConclusionsThe levels of serum resistin in patients with NAFLD were significantly higher than those of controls.Serum resistin in patients with NAFLD was closely correlated with insulin resistance,and it may participate in the pathogenetic progress of NAFLD.Serum resistin in patients with NAFLD might be associated with hepatic insulin resistance,and it has no correlations with obesity-related insulin resistance.Serum resistin in patients with NAFLD may participate in the inflammation of fatty liver disease as inflammatory cytokines.

Object To study the chemical constituents of the root bark of Lycium chinense Mill Methods Various chromatographic techniques were used to separate and purify the constituents Their structures were elucidated on the physico chemical properties and spectral data Results Five compounds were isolated from the root bark of L chinense and identified as vanillic acid (Ⅰ), apigenin (Ⅱ), linarin (Ⅲ), glucosyringic acid (Ⅳ) and digupigan A (Ⅴ) Conclusion Digupigan A is a new compound. Except vanillic acid, others were isolated from this plant for the first time

Objective To study the efficacy of treating fatty liver with reduced glutathione and Danshen root,and computed tomography was applied for quantitative measurement of efficacy.Methods 38 patients with fatty liver disease were treated with reduced glutathione and Danshen root for 4 weeks,before and after treatment liver function,serum lipid and imaging change were observed.Results Serum ALT reduced from (205.4±9.7) U/L to (87.4±5.3) U/L,TC reduced from (7.8±1.3) mmol/L to (4.2±1.0) mmol/L,TG reduced from (2.7±0.3) mmol/L to (1.6±0.3) mmol/L,after treatment,attenuation of liver have raised from (26±8) Hu to (37±11) Hu after treatment,all values before and after treatment have significant difference (P＜0.01).Conclusion Reduced Glutathione and Danshen Root have favorable results in treating fatty liver disease and worthy of clinical application,attenuation of liver can be applied for quantitative measurement of efficacy and worthy of further study.

Objective To observe the clinical efficacy of electrothermal needle apparatus in treating mild hip osteoarthritis.Method Ninety patients were divided into a control group and a treatment group by using the random number table, 45 cases in each group. The treatment group was intervened byelectrothermal needleapparatus; the control group was treated with ordinary electroacupuncture plus TDP radiation. After 15-day treatment, the therapeutic efficacies of the two groups were evaluated by using Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) scores.Result The VAS and JOA scores were improved inthe two groups after the treatment (P<0.05), and the improvements in the treatment group were more significant than those in the control group after the 15-day treatment (P<0.05).Conclusion Electrothermal needle apparatus can produce a significant therapeutic efficacy in treating mild hip osteoarthritis.

Objective To study the clinical effect of cervical loop electrosurgical excision procedure (LEEP) in diagnosis and treatment of cervical diseases (including cervical intraepithelial neoplasia of different grade, cervical erosion of moderate and severe degree, cervical with human papillomavims (HPV) infection and cervi-cal polyp) . Method The data of 136 cases with cervical disease treated by LEEP were analyzed retrospectively. Re-sult The postoperative diagnosis were upgraded in 18 cases (13.2%) ,and downgraded in 38cases (27.9 %) . The preoperative diagnosis of 80 cases (58.8 %) were in accordance with the postoperative ones. The difference was sig-nificant(P<0.05). The mean operative time was 11minutes, the mean bleeding volume was 15 ml. Postoperative bleeding of LEEP occurred in 2.2 % (3/136) patients. Postoperative cervical conglutination of LEEP occurred in 1. 5 % (2/136) patients. The cure rate of CIN was 96 % after LEEP. The residual CIN occurred in 4 patient (4 %). Recurrence CIN occurred in 2 patient (2 %). At 12th months after LEEP,the negative rate of HPV detection was 86. 7% and the persistent positive rate was 13.3%. The HPV clearance rate was increased gradually after LEEP. Conclu-sion LEEP was safe and effective for the treatment of the cervical disease and was a kind of good method to clear HPV infection in cervical.

This thesis described the necessity for practicing the tutorial system of specialist training in Chinese medical education,the essential basic elements for the construction of the tutorial system of specialist training and also the necessity for further exploration in the patterns of the tutorial system of specialist training in China.

Objective To study the role of Foxp3 + CD4 + CD25 + regulatory T cells(Foxp3 + CD4 + CD25 + Tregs) and Foxp3mRNA in pathogenesis of passive transferred myasthenia gravis(PTMG) by detecting their expression in a PTMG model.Methods Sixteen C57BL/6 young female mice were divided into model group and control group.A PTMG model was established by injecting Ringer's solution containing 1.0 mg/kg mAb35 into abdominal cavity.Mice in control group were injected with Ringer's solution not containing mAb35.Levels of CD4 + CD25 + T cells and Foxp3 + CD4 + CD25 + Tregs in spleen cells were measured by flow cytometry.Expression of Foxp3 mRNA in spleen cells was detected by real-time fluorescent quantitative polymerase chain reaction(RT-FQ-PCR).Serum level of interleukin-2 and interferon-? was detected by ELISA.Results The ratio of CD4 + CD25 + T cells and CD4 + T cells was higher in model group(8.82 ? 0.74)% than in control group(9.89 ? 0.88)%(P

Objectives To study the expression patterns of steroid receptor coactivators (SRC) and steroid-induced stromal cell-derived factor-1 (SDF-1) in endometriosis,and to explore the roles of SRC in the steroid-induced SDF-1 expression endometriosis.Methods From May 2010 to October 2012,16 endometriosis cases at stages Ⅲ or Ⅳ according to the revised American Society for Reproductive Medicine classification undergoing surgery in the First Affiliated Hospital to Nanjing Medical University were enrolled in this study.Their ectopic endometrium were from ovarian endometriomata which were identified pathologically with 9 cases at proliferative phase and 7 cases at secretory phase.The normal endometrium were acquired from the healthy women with normal menstrual cycle (n =10,proliferative phase =5,secretory phase =5).The mnRNA levels of SRC and SDF-1α during the menstrual cycle were detected by quantitative real-time polymerase chain reaction.Ectopic endometrium stromal cells were purified and cultured in medium containing 17β-estradiol (10-8mol/L) or 17β-estradiol (10-8 mol/L) + progesterone (10-6 mol/L).At 24,48,72 and 96 hours,the supernatants were collected to measure SDF-1α expression by ELISA.Ectopic endometrium stromal cells were transfected respectively with siRNA of SRC-1 and SRC-2 using lipofectamine.Two days after transfection,17β-estradiol (10-8 moL/L) or 17β-estradiol (10-8 mol/L) + progesterone (10-6 mol/L) were added into the media.On the third day after the steroid hormones treatment,the media were collected to quantify SDF-1α expression with ELISA.Results (1) Cyclical changes: the SRC-1,SRC-2 and SDF-1 α showed marked cyclic differences in normal endometrium (P ＜ 0.05).In proliferative phase and secretory phase,the SRC-1,SRC-2 and SDF-1 α were 5.6 ± 1.2,3.8 ± 1.1,2.7 ± 0.5 and 2.6 ± 1.0,2.1 ± 1.0,1.6-± 0.5,respectively.There was no periodic variation in the expression of SRC-1,SRC-2 and SDF-1α in ectopic endometrium throughout the menstrual cycle.(2) Steroid-induced SDF-1α expression in ectopic endometrium stromal cells: the 17β-estradiol-induced SDF-1α expression was (1 803 ± 196),(2 272 ± 261) and (2 162 ± 258) ng/L at 48,72 and 96 hours.At the same time points,the SDF-1α expression induced by 17β-estradiol and progesterone was (1 307 ± 150),(1 518 ± 301) and (1 550 ± 144) ng/L,respectively.There was significant difference between two groups (P ＜0.05).(3) The effects of SRC silencing on steroid hormones-induced SDF-1 α expression in ectopic endometrium stromal cells: the expression of 17β-estradiol-induced SDF-1α at 72 hours was significantly decreased from (2 313 ± 357) ng/L to (1 155 ± 244) ng/L after the silencing of SRC-1 (P ＜ 0.05).After the silencing of SRC-2,the 17β-estradiol-induced SDF-1 α at 72 hours was (1 958 ±324) ng/L.There was no significant difference compared with the before the silencing (P ＞ 0.05).The expression of SDF-1 α at 72 hours induced by 17β-estradiol + progesterone was (1 534 ± 449) ng/L and (2 051 ± 380) ng/L respectively before and after the silencing of SRC-2 and showed the significant difference (P ＜ 0.05).Conclusion During the expression of SDF-1 α regulated by steroids in ectopic endometrium cells,SRC-1 is the major coactivator of 17β-estradiol and SRC-2 is the major coactivator of progesterone.

Objective To investigate the effect of anti-inflammation-analgesic injection (AIAI) combined with extract from rabbit skin inflamed by vaccinia virus (ERSVV) on repair of the damaged sciatic nerve in rats.Methods Fifty adult SD rats of both sexes weighing 260-300 g were randomly divided into 5 gronps ( n = 10each): sham operation group (group S); sciatic nerve chronic constriction injury group (group CCI); CCI + AIAI group (group A); CCI + ERSVV group (group E) and CCI + AIAI + ERSVV group (group A + E). Right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4/0 catgut in CCI,A,E and A + E groups. A catheter was placed around sciatic nerve, and fixed to the nearby muscle and kept unclogged by injecting 0.2 nl distilled water daily. AIAI and/or ERSVV 0.2 ml were injected via the catheter starting from the 14th day after operation. AIAI 0.2 ml contained dexamethasone palmitate (4 mg/ml) 0.05 ml, 2% lidocaine 0.05 ml and vitamin B12 (0.5 mg/ml) 0.05 ml in distilled water. Dexamethasone palmitate was omitted in AIAI starting from the 2nd of drug administration in group A and A + E. Paw withdrawal threshold to mechanical stimulation (MWT) was measured before (baseline) and at 1, 5, 7, 14, 21 and 28 days after operation. Sciatic nerves were exposed at 14 and 28 days after operation in 5 rats in each group. Conduction velocity of motor nerve (NCV) and action potential (AP) of gastrocnemius muscle were measured. Sciatic nerve at the site of CCI was examined for pathologic changes, the number of axons (NA) and thickness of myelin sheath (TMS) with light microscope. Results CCI significantly decreased MWT, AP, NA, TMS and NCV in group CCI as compared with group S (P ＜0.01). AIAI and/or ERSVV significantly attenuated CCI-induced decrease in MWT, AP, NA, TMS and NCV in A,E and A + E groups as compared with CCI group ( P ＜ 0.05). Their curative effects were potentiated by combined use. Conclusions Both AIAI and ERSVV have curative effects against CCI-induced sciatic nerve injury and their actions are potentiated by combined used.

Objective To evaluate the antineoplastic effect of laser immunotherapy in mice with multiple cutaneous squamous cell carcinoma (CSCC).Methods Normal immunocompetent hairless SKH-1 mice were consecutively irradiated by ultraviolet rays to establish mouse models of multiple CSCC.Then,20 CSCC-bearing mice were randomly and equally divided into 4 groups:laser group irradiated with an 808-nm near-infrared laser (1 W/cm2,10 minutes) once every two weeks for a total of 3 sessions,laser immunotherapy group irradiated with an 808-nm nearinfrared laser as above and topically treated with imiquimod cream once a day for 3 days before and after each session of irradiation,imiquimod group treated with imiquimod cream as in the laser immunotherapy group,and control group receiving no treatment.The volume of tumors was calculated,and their morphology as well as the survival of mice were observed after the treatment.The t test and Mantel-Cox log-rank test were used to compare the volume of tumors on the dorsum and survival rates of mice,respectively,on days 27 and 60 after the start of treatment.Another 12 CSCC-bearing mice were randomly and equally divided into the 4 groups mentioned above,and tumor tissues were resected from these mice for histopathological examination on day 5 after the first treatment.Results On day 27,the volume of tumors significantly increased in the control group and imiquimod group (both P ＜ 0.05),but experienced no significant increase in either of the other two groups compared with that before the start of treatment (both P ＞ 0.05).Moreover,the volume of tumors in the control group was slightly larger than that in the imiquimod group (P ＞ 0.05),but significantly larger than that in the laser group and laser immunotherapy group (both P ＜ 0.05).The volume of tumors in the laser group increased,and was significantly larger than that in the laser immunotherapy group on day 60 (P ＜ 0.05).Mice all died within 40 days in the control group,and within 50 days in the imiquimod group;one mouse died on days 52 and 53 separately,and the other mice all survived longer than 60 days in the laser group;no mice died within 60 days in the laser immunotherapy group.By day 60,the survival time of mice was slightly longer in the imiquimod group (P ＞ 0.05),significantly longer in the laser group and laser immunotherapy group compared with the control group (both P ＜ 0.05),but similar between the laser group and laser immunotherapy group (P ＞ 0.05).Histopathological examination showed that 5-day topical application of imiquimod cream did not cause death of tumor cells,but numerous tumor cells died in the laser group and laser immunotherapy group.Multiple inflammatory cells were observed around the tumors,and the number of the inflammatory cells was obviously larger in both the laser group and laser immunotherapy group,especially in the latter group,compared with the control group.Conclusion Laser immunotherapy is a new effective and safe treatment for CSCC in mice,and has potential value especially in the treatment of multiple or metastatic CSCC.