Objective To establish the cell line stably expressing INSIG2 and observe its effecet on fat metabolism after overexpression of INSIG2.Methods The eukaryotic expression plasmid pcDNA3.1(+)-INSIG2 was constructed,which was transfected into 3T3-L1 cells.The expression of INSIG2 and related genes were detected by RT-PCR and immunohistochemistry,the contents of FFA in cell culture medium and adipocyte differentiation were detected by ELISA and Oil Red "O"staining respectively.Results After pcDNA3.1(+)-INSIG2 was transfected into the 3T3-L1 cells,the expression of INSIG1 mRNA and FAS mRNA were down-regulated,the content of FFA in the cell culture medium was decreased and adipocyte differentiation was drepressed.Conclusion The cell line stably expressing INSIG2 was successfully established,the transfected INSIG2 may have a drepressant effect on fat metabolism.

Objective To investigate the efficacy and safety of combination of transcatheter arterial chemoembolization (TACE)and percutaneous radiofrequency ablation (RFA)in treatment of hepatocellular carcinoma (PHC).Methods 70 cases of PHC were divided into combined group (TACE +RFA,n =37) and control group (only TACE,n =33).Patients were followed up for1 to 2 years,and the therapeutic effects and side effects were compared between the two groups.Results The patients with tumor completely necrosis and AFP level lower than >50% in combined group were significantly more than those in control group (P <0.05);the half of year,one year and two years survival rate in combined group were greatly higher than those of control group;no severe side effect was observed in two groups.Conclusions TACE+RFA is effective and safe in treatment of PHC of more than 5 cm in diameter.

Objective To detect the serum expression level of Pokemon and explore its clinical value combines with AFP,AFP-L3 or DCP in hepatocellular carcinoma (HCC).Methods In this study,the serum levels of Pokemon,AFP,AFP-L3 and DCP in 30 patients with HCC,34 patients with benign liver diseases and 30 healthy controls were examined by enzyme-linked immunosorbent assay.Then,the clinical significance of Pokemon expression level was analyzed.In the end,the diagnostic evaluation of four serum biomarker alone detection was used to analyze the sensitivity,specificity,the area under the curve and Youden index in the diagnosis of HCC.Results The serum expression level of Pokemon in patients with HCC was (22.63 ± 6.82) ng/ml,which was significantly higher than that in the group with benign liver diseases and healthy controls [(3.54±1.26)ng/ml,t =8.594,P＜0.001;(1.95 ±0.57)ng/ml,t =10.021,P＜0.001].The expression level of Pokemon in HCC patients was correlated to tumor size (t =2.678,P =0.021) and TNM stag (t =2.578,P =0.034).The serum expression levels of AFP,AFP-L3 and DCP in patients with HCC were (774.56 ± 96.52) ng/ml,(26.37 ± 2.54) ng/ml and (93.49 ± 30.45) mAU/ml,which were significantly higher than those in the group with benign liver diseases [(22.21 ± 3.57) ng/ml,(7.05 ± 2.71) ng/ml,(34.68 ± 10.13) mAU/ml] and healthy controls [(14.65 ± 4.45) ng/ml,(3.84 ± 1.09) ng/ml,(25.87 ± 9.01)mAU/ml,F=58.46,P=0.000;F=12.47,P=0.000;F=23.41,P=0.000].The sensitivity and specificity of Pokemon,AFP,AFP-L3,DCP in the diagnosis of HCC were 84.6％ and 87.5％,52.5％ and 78.9％,95.0％ and 80.0％,77.1％ and 87.5％,respectively.Conclusion The enhanced Pokemon serum level,with its sensitivity and specificity higher than AFP,points out Pokemon may be a potentially useful biomarker to diagnose HCC.

Objective To explore the value of E-flow technique in ultrasound examination of fetal pulmonary vein.Methods The pulmonary veins of 332 fetus were examined using lungs as acoustic window by two-dimensional echocardiography(2DE), color Doppler flow imaging (CDFI) and E-flow.Visualization ratios of the three methods were compared.Results The fetal pulmonary veins were displayed as following:7 cases were showed by 2DE,49 cases by CDFI and 73 cases by E-flow among 118 cases during 12 - 22 gestational weeks.The visualization ratio of E-flow was higher than that of the other two methods (P ＜0.001).Fourty-one cases were showed by 2DE, 171 cases by CDFI and 177 cases by E-flow among 214 cases during 23 - 40 gestational weeks.The visualization ratios of E-flow and CDFI were higher than that of 2DE (P ＜ 0.001).The visualization ratio of E-flow and CDFI has no distinct differrence (P ＞ 0.0167).Conclusions E-flow was sensitive to pulmonary vein blood flow and better than 2DE and CDFI in early stage of the second trimester.

Objective To evaluate the impact of vagal denervation (VD) that is derived from circumferential ablation of pulmonary vein ostium for paroxysmal atrial fibrillation (AF) on the therapeutic results. Methods A total of 50 patients with paroxysmal atrial fibrillation were enrolled in this study. Circumferential ablation of pulmonary vein ostium was carried out in all the patients. The end point of ablation was pulmonary vein electricity isolation. The patients in whom VD occurred during the performance of ablation were regarded as VD- positive group (n = 19), and the remaining patients were used as VD- negative group (n = 31). The recurrence rate of AF six months after the treatment was recorded, and the results were compared between the two groups. Results The end point of ablation was successfully achieved in all the fifty cases. Six months after the ablation, the therapeutic effect of VD- positive group was significantly better than that of VD- negative group (84.21% vs 64.51%, P ≤ 0.05). Conclusion The vagal denervation effect that is derived from circumferential ablation of pulmonary vein ostium in treating AF can significantly increase the success rate of radiofrequency ablation for AF.

【Objective】To observe the effect of fucoidan on lipid metabolism enzyme in hyperlipidemia mice.【Methods】Sixty healthy male SD rats were randomized into 6 groups: normal group,model group,gynostemma pentaphyllum(GP,30 mg/kg) group and low-,moderate-and high-dose fucoidan groups(0.1,0.2 and 0.4 g?kg-1 respectively).Except the normal group,the rats in other groups received high fat emulsion(10 mL?kg-1) by gavage to establish hyperlipidemia models.The activities of lipoprotein lipase(LPL),hepatic lipase(HL) and lecithin cholesterol acyltransferase(LCAT) in different groups were compared.【Results】Serum activities of LPL,HL and LCAT as well as hepatic activities of LPL and HL were increased in low-and moderate-dose fucoidan groups.【Conclusion】Fucoidan decreases the serum triglyceride levels by activating the serum and hepatic LPL and HL activities,and decreases serum cholesterol level by activating hepatic LCAT activity.

Objective To explore the mechanism of Fudoidan for regulating the disorder of lipid metabolism in rats. Methods Rat hyperlipidemic model was established. The effect of Fudoidan on rats levels of blood lipids, lipid metabolic enzyme, and the lipid contents in the stool, as well as bile metabolismand LDL-R mRNA expression in the liver were observed. Results Fudoidan can notably restrain the concentration of serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) of hyperlipidemic rats and increase the concentration of high-density lipoprotein cholesterol (HDL-C) and activities of 1ipoprotein lipase (LPL), hepatic lipoprotein (HL) and lecithin cholesterol acyltransferase (LCAT).Fucoidan can remarkably increase the contents of cholesterol, TG, bile acid , but has no effect on the secretion of bile, the concentration of cholesterol and bile acid in bile. The results of RT-PCR experiment showed that Fudoidan can notably improve the expression level of low-density lipoprotein receptor (LDL-R) mRNA in the liver of hyperlipidemic rats. Conclusion Fucoidan can regulate the disorder of lipid metabolism probably by restraining the absorption of lipids (TC, cholesterol, bile acid) , activating the activities of lipid metabolic enzyme (LPL, HL and LCAT), and promoting the expression of LDL-R mRNA in the liver.

Objective To discuss the clinical outcomes of old fracture-dislocation of proximal interphalangeal joint treated with a self-made distraction external fixator which consists of 3 pins and rubbers.Methods From March 2005 to August 2011,8 cases of old fracture-dislocation of proximal interphalangeal joint treated with a pins-rubber distraction external fixator were retrospectively reviewed.There were 6 males and 2 females,aged from 17 to 58 years,averaged 23.2 years.The middle finger was involved in 5 cases and ring finger was involved in 3 cases.The right hand was affected in six patients,and the left hand was affectd in two patients.The mechanism of injury was sports injury in 6 cases,traffic injuries in 1,and sprain in 1.All of the cases were closed injury.The mean time from injury to surgery was 58 d (range,45-90 d).According to Schenck classification of the proximal interphalangeal joint fracture-dislocation,there were 4 cases of type Ⅰ,3 of type Ⅱ,I of type Ⅲ.Based on the Michigan Hand Outcomes Questionnaire (MHQ) for subjective hand function score,the average preoperative score was 56; the range of motion of proximal interphalangeal joint was 0°.Grip strength was 60％-80％ of the contralateral hand.Results The follow-up lasted 6-51 months,with a mean period of 20.5 months.Solid bone healing was eventually achieved in all patients.The average healing period was 3 months (range,2-5 months).The mean normalized MHQ score was 88 (range,84-92).Grip strength was 85％-100％ of the contralateral hand.Extension of proximal interphalangeal joint was -10°-0° (average,-5°).Flexion angle was 75°-100° (average,89.4°).Postoperative complications included slight joint space narrowing (2 cases),joint incongruity (＜ 1 mm) (2 cases) and fusiform arthrocele (2 cases).No infection,pin loosening,and pin breakage was encounted.Conclusion A pins-rubber distraction external fixator is a minimally invasive,reliable and effective treatment for old fracture-dislocation of proximal interphalangeal joint.

Objective To observe the effects of high fat diet on ulcerative colitis(UC)and atypical hyperplasia in different periods induced by azoxymethane(AOM)/dextran sodium sulfate(DSS)and the changes of interleukin-6(IL-6)level in blood. Methods The mice in DSS,DSS+AOM,DSS+high fat diet,and DSS+AOM+high fat diet groups were given DSS for 3 days and sterilization water for 4 days as one cycle for 9 cycles, and the mice in normal control group were given sterilization water(n=12 in each group). The mice in DSS+AOM and DSS+AOM+high fat diet groups received intraperitoneal injection of AOM(10 mg/kg)in the every first day of the first 3 cycles. The mice in each group were sacrificed at different time points,and the disease activity index and pathohistological index were used to determine the degree of inflammation. ELISA method was used for the detection of serum IL-6 level. Results Simple administration of DSS could induce UC in the mouse model. After 9 circles of treatment,atypical hyperplasia was not found in normal control and DSS groups,and the rate of atypical hyperplasia was 25%(1/4)in DSS+high fat diet group,50%(2/4)in DSS+AOM group,and 75%(3/4)in DSS+AOM+high fat diet group. However,there were no significant differences in the rate of atypical hyperplasia between DSS and DSS+AOM groups ,DSS+high fat diet and DSS+AOM+high fat diet groups ,DSS and DSS+high fat diet groups,and DSS+AOM and DSS+AOM+high fat diet groups(all P>0.05). The histopathological score and the disease activity index in DSS+high fat diet and DSS+AOM+high fat diet groups were higher than those in DSS and DSS+AOM groups(P<0.05). The IL-6 level in DSS+high fat diet and DSS+AOM+high fat diet groups was higher than that in DSS and DSS+AOM groups ,but the difference was not statistically signifi-cant(P>0.05). Conclusion High fat diet may be one of the stimulating factors of UC and atypical hyperplasia.

Objective To determine if urinary cystatin C (uCys C) level can predict mortality in critically ill neonates.Methods This prospective study included neonates admitted to the intensive care unit within the first 6 hours of life from May.2011 to Oct.2012.Neonates were assigned into survivor and non-survivor groups based on whether they died during the first week of life.The uCys C level was measured on the day of admission.The score for neonatal acute physiology (SNAP) was calculated based on 28 items collected during the first 24 hours of admission.Multivariate Logistic regression analysis was used to determine whether uCys C level was a predictor of mortality.A receiver operating characteristic (ROC) curve was constructed and the area under the ROC curve (AUC) was calculated to assess the predictive strength.Results Of the total 155 neonates,12 cases (7.1％) died during the first week of life.When compared to survivors,the gestational age (t =2.810,P =0.006) and birth weight (t =3.245,P =0.001) in non-survivors were significantly lower; but the uCys C level (z =-3.426,P =0.001),the SNAP score (z =-3.308,P =0.001),and the use of mechanical ventilation (x2 =23.877,P =0.000) were significantly higher.Logistic regression analysis revealed that uCys C remained significantly associated with mortality after adjusting for gestation age,birth weight,or the SNAP score (P =0.024).uCys C achieved AUC of 0.81 (95％ CI:0.71-0.92,P =0.001).When combined with SNAP and mechanical ventilation,the predictive performance of uCys C improved AUC 0.93 (95 ％ CI:0.86-1.00,P =0.000).Conclusion uCys C is significantly associated with adverse outcome of death and independently predictive of mortality in critically ill neonates.