Objective To investigate the association between HbA1c status,arterial stiffness and endothelial function in subjects with type 2 diabetes mellitus(DM).Methods The study group consisted of 338 DM patients,including 74 subjects with normal HbA1c(≤ 6.0％)(Group A),102 subjects with mildly increased HbA1c(HbA1C increased by less than 6.5％)(Group B)and 162 patients with high HbA1c level (HbA1c increased by more than 6.5％)(Group C).All patients were evaluated for glucose,HbA1c,TC and TG.Pulse wave velocity(PWV)and flow-mediated dialation(FMD)were performed simultaneously.Results Compared with Group A,Group B and C had higher baPWV([1734 ± 343]cm/s vs.[1537 ± 313]cm/s and [1853 ± 364]cm/s vs.[1537 ± 313]cm/s).Patients in Group C had a higher baPWV than those in Group B ([1853 ± 364]cm/s vs.[1734 ± 343]cm/s,P =0.006).The patients in group A had a lower level of FMD than that of group B and C([4.20±3.13]％ vs[5.29±3.92]％,[4.09±2.79]％ vs.[5.29±3.92]％,P＜0.01).Leaner association analysis showed a positive correlation between baPWV and HbAlc(r =0.53,P ＜0.01).baPWV was negatively correlated with FMD(r =-0.25,P ＜0.01).Logistic regression analysis showed that HbA1c(OR32.19％,CI 11.26 ～53.12,P＜0.001),age(OR 14.21,95％ CI 11.43 ～ 17.00,P＜0.001),systolic blood pressure(OR 7.36,95％ CI 6.12-8.59)and TC(OR:0.31,95％ CI:9.97-70.64)were independent predictors for the increased arterial stiffness(baPWV).Conclusion Arterial stiffness parameters varied significantly across subgroups of patients with different levels of HbA1c and the arterial stiffness was positively associated with deranged glucose homeostasis.

Moxibustion dose, closely related to moxibustion methods and sensations, directly influences the efficacy. Moxibustion dose is affected by quantity factors and patients' sensations. Quantity factors are volume and number of moxa cones, and moxibustion time and frequency, etc. The relationship between moxibustion dose and efficacy is discussed from quantity factors and sensations in the paper.
Humans ; Moxibustion ; methods ; standards ; Sensation ; Time Factors

BACKGROUND: Scoliosis is a complex three-dimensional plane deformity, including lateral bending on the coronal plane, before physiological kyphosis reduction or increase in the sagittal plane, the rotational deformity of the spine in the axial plane. The method of ful decompression, maximum reconstruction of spinal balance in coronal and sagittal plane, long-segmental fixation and short-segmental fusion is the more ideal orthopedic method for degenerative scoliosis. OBJECTIVE: To analyze the characteristics of scoliosis fixation system. METHODS: The articles about scoliosis fixation system were retrieved from PubMed database, Chinese Journal Ful -text database from 1999 to 2015 by the first author using computer. “Scoliosis, Internal Fixation, Three-dimensional Correction” were taken as the search terms in English and Chinese. Total y 163 relevant articles were retrieved, and eventual y 34 articles met the inclusion criteria. RESULTS AND CONCLUSION: With the development of fixation materials, the spinal fixation system which was designed based on three-dimensional orthopedic concept of spine is a dynamical y developed system. The goal is to restore the balance of spine in three dimensions as comprehensive as possible. At present, the general spinal system within very broad application includes TSRH spinal fixation system, ISOLA spinal internal fixation system, Moss Miami spinal fixation system, CD Horizon spinal internal system and China Great Wal spinal fixation system. Spinal fixation system possesses three-dimensional orthopedic capability, and can correct the spinal deformity in coronal and sagittal plane, and biomechanics is reasonable, fixed and reliable. Bone grafting material is the key factor of preventing breakage of internal fixation, screw extraction and other complications. Compared with such bone grafting materials made of autologous bone, al ograft bone and xenograft bone, artificial bone can shorten the orthopedic time and reduce the risk of concurrent diseases because of bone grafting, which is the future trend of bone grafting material. Meanwhile, three-dimensional reconstruction has been used in clinical practice, and can develop programs for scoliosis orthopedic treatment, provide imaging reference to ensure the security of internal fixation and also has played a huge role in improving the comprehensive efficacy of spinal internal fixation system.

Objective To summarize the theoretic evidence of Shenmen (HT7) Point in the treatment of insomnia and its action mechanism, for guiding clinical application. Method The reasons and evidences for using acupuncture at Shenmen to treat insomnia were summarized from the following 3 aspects: records in the ancient literatures, clinical application, and modern medical studies. Result Acupuncture at Shenmen can produce a calming and sedative effect, and it should be one of the optimal choices for treating insomnia due to its significant efficacy; it calms the mind and improves sleep quality via activating the nervous center for regulating sleep and promoting the secretion of neurotransmitters such as 5-hydroxytryptamine (5-HT) in brain. Conclusion Acupuncture at Shenmen is an effective method is treating insomnia.

BACKGROUND:It is a very difficult task to transfer from the animal model of cervical spondylosis to clinical treatment. However, the pathology of cervical spondylosis is not very clear, and the main reason is the lack of an ideal animal model of the experiment.
OBJECTIVE:To review the commonly used modeling methods and evaluate the advantages and disadvantages of different modeling methods through consulting literatures.
METHODS:The key words were“cervical spondylosis, cervical spondylotic myelopathy, cervical spondylotic radiculopathy, vertebroarterial type of cervical spondylosis, animal model”. The first author retrieved Medline and CNKI for studies published from 1991 to 2015 concerning animal experiments or clinical studies on the construction of animal model of cervical spondylosis. Final y, 41 studies were included for reviewing.
RESULTS AND CONCLUSION:There are many methods for the modeling of cervical spondylosis at the present stage, including implantation method, screw insertion method, bal oon compression method, mechanical compression, injection method, spinal suture method and mechanical imbalance method. Each has its advantages and disadvantages. In the study of cervical spondylosis, we should choose the appropriate animal model according to the research purpose. Further research and the establishment of a comprehensive animal model are stil the goal of efforts.

In this paper,the classification,application and advantages of three-dimensional (3D) printing in biomedical engineering are summarized.The working principles of 3D printing,stereolithography,fused deposition modeling,selective laser sintering and 3D spray printing,as well as merits,demerits and recent progress are reviewed.The 3D printing has been widely used in the synthetic of bone tissue engineering scaffolds,with biodegradable and bioactive materials in the scaffold.Synthetic bone materials and surgical simulation by 3D printing technology are increasingly common and has achieved satisfactory results in China.Although 3D printing technology has developed rapidly,development of suitable biomaterials and improving relevant techniques are still urgent issues.Up to now,the functionalization of bionic organs is the most difficult issue,in which the cell co-culture,vascularization and preparation of the scaffolds are problem to be solved.The 3D printing technology will make remarkable achievements for the regeneration and repair of human organ through our efforts.

BACKGROUND:With the development of atlantoaxial morphology, applied anatomy and biomechanics, pathogenesis, diagnosis and treatment of atlantoaxial instability have attracted more and more attention. However, the development of effective fixation for atlantoaxial instability is relatively late, so scholars al over the world have made numerous studies. OBJECTIVE:To compare biomechanical functions of different fixations through atlantoaxial posterior approach, and to assess its stability. METHODS:We retrieved recent studies on comparative biomechanical evaluation and its primary clinical application of different posterior approaches in repair of atlantoaxial instability, and conducted a retrospective analysis by measuring the three-dimensional range of movement in normal atlantoaxial complex and atlantoaxial instability models. This analysis evaluated the stability of different fixations under normal three-dimensional atlantoaxial movement, and provided a biomechanical basis for reasonable fixator selection.
RESULTS AND CONCLUSION:Atlantoaxial posterior fixation included Gal ie wire fixation, Brooks fixation, Apofix and Halifax vertebral plate hook fixation, screw fixation through joint and atlantoaxial pedicle nail/rod fixation. Gal ie technique contributes to the reduction of anterior semiluxation, but its mechanical stability is poor. Brooks technique has strong rotation and stretch forces. Apofix and Halifix vertebral plate hook device provides strong anti-rotation and anti-antelocation strength, and is more stable than Gal ie technique in mechanics. The biomechanics of screw fixation through joint was better than wire technique and Halifax. The screw fixation avoids occipitocervical fusion, and has a high requirement to instal ation. When an internal fixator was selected, immediate cervical vertebra stability should be provided to protect spinal cord functions. Upper neck functions should be maintained to reach reduction and maintenance of occipital bone, atlas and axis. A suitable fixation method should be selected for each patient.

Objective To evaluate the role of protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway in ulinastatin-induced reduction of oxidative stress injury to cardiomyocytes of rats.Methods H9c2 cells were inoculated in 96-well plates at a density of 104 cells/well.The cells were divided into 5 groups using a random nomber table:control group (group C,n =12),H2O2 group (n=12),H2O2 plus ulinastatin group (group HU,n=12),H2O2 plus ulinastatin plus LY294002 group (group HUL,n=9) and H2O2 plus LY294002 group (group HL,n=9).In group H2O2,H2O2 (final concentration 200 μ mol/L) was added,and the cells were incubated for 12 h in the incubator.In HU,HL and HUL groups,ulinastatin (final concentration 50 U/ml),LY294002 (final concentration 10 μmol/L),and ulinastatin (final concentration 50 U/ml) plus LY294002 (final concentration 10 μmol/L)were added,respectively,the cells were incubated for 2 h,H2O2 (final concentration 200 μmol/L) was then added,and the cells were incubated for 12 h in the incubator.The cell survival rate was measured by methyl thiazolyl tetrazolium assay.The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were determined by using water soluble tetrazolium-1 and thiobarbituric acid colorimetric assays.Cell apoptosis was measured by flow cytometry,and apoptosis rate (AR) was calculated.The expression of Akt,phosphorylated Akt (p-Akt),mTOR,phosphorylated mTOR (p-mTOR),activated caspase-3 and activated poty-ADP-ribose polymerase (PARP) was detected by Western blot.The p-Akt/AKT and pmTOR/mTOR ratios were calculated.Results Compared with group C,the cell survival rate was significantly decreased,AR was increased,the SOD activity was decreased,the MDA content was increased,the expression of activated caspase-3 and PARP was up-regulated (P＜0.05),and no significant change was found in p-Akt/AKT ratio or p-mTOR/mTOR ratio in group H2O2 (P＞0.05).Compared with group H2O2,the cell survival rate was significantly increased,AR was decreased,the SOD activity was increased,the MDA content was decreased,the p-Akt/AKT and p-mTOR/oTOR ratios were increased,and the expression of activated caspase-3 and PARP was down-regulated in group HU (P＜0.05).Compared with group HU,the cell survival rate was significantly decreased,AR was increased,and the expression of activated caspase-3 and PARP was up-regulated in group HUL (P＜0.05).Conclusion The mechanism by which ulinastatin reduces oxidative stress injury to cardiomyocytes is related to activation of Akt/mTOR signaling pathway in rats.

Objective To evaluate the method of endoscopic band ligation in resecting upper gastrointestinal leiomyoma . Methods We selected 59 patients with 64 small upper gastrointestinal tract leiomyo-mas by endoscopy , EUS and EUS guided fine needle aspiration. Of the 64 leiomyomas, their distribution were in esophagus 50, stomach 12 and duodenum 2. When the endoscope with transparent cap was introduced to reach the lesion, it was sucked into the cap, then released the band to ligate it. Two weeks after operation, endoscopic monitoring of the lesion was performed weekly until the complete healing of the wound. Results In the 64 lesions, 50 esophageal and 2 duodenal leiomyomas were thoroughly resected and the mean concrescence time is 3. 1 weeks and 4. 5 weeks respectively. Nine of 12 gastric leiomyomas were resected thoroughly and the other 3 were partially ligated and resulted in incomplete excision with the mean concrescence time of 4. 5weeks. No perforation occurred. Conclusions Endoscopic band ligation is an ideal method in resecting the small upper gastrointestinal leiomyomas.

Objective To investigate the effects of maternal deprivation on chronic stress?induced depression behavior and its characteristics in adult rats,and to evaluate the effects of maternal deprivation on the efficacy of escitalopram. Methods Newborn SD male rats were randomly divided into control ( C ) group,maternal deprivation (MD) group,chronic unpredictable stress (CUPS) group,maternal deprivation and chronic unpredictable stress ( MD+CUPS) group. Rats in control group received no experimental han?dling.Rats in MD group and MD+CUPS group received maternal deprivation from the lst day after birth for 14 days.Rats in CUPS group and MD+CUPS group received chronic unpredictable stress from 10 th weeks after birth for 28 days. Screened the rats with depression behaviors and treated them with escitalopram for 4 weeks. Results The incidence of anhedonia was significantly different among 4 groups (χ2=143.24, P<0.05). Pairwise comparison showed significant difference between any two groups (MD+CUPS group (75.76%) >CUPS group (40.98%) > MD group (17.11%) >C group (4.17%), P<0.0083). The incidence of behav?ioral despair was significantly different among 4 groups (χ2=70.34, P<0.05). Pairwise comparison showed the incidence of behavioral despair in MD+CUPS group (43.43%) and CUPS group (39.34%) were signifi?cantly higher than that in MD group (13.51%) and C group (3.33%),but no difference was observed be?tween MD+CUPS and CUPS group (P<0.0083) . The incidence of behavioral despair in MD group was signif?icant higher than that in C group. There was no significant efficacy of escitalopram on anhedonia and behav?ioral despair among 3 stressed models. However the recovery incidence from anhedonia (44/140) was significantly lower than that from behavioral despair (76/140) (χ2=14.93, P<0.05). Conclusion The maternal deprivation in?creases the stress sensitivity and the incidences of anhedonia in adult rats.The efficacy of escitalopram on behavioral despair is higher than that on anhedonia without influence from maternal deprivation.