Recently many researches have demonstrated that insulin resistant (IR), as an important pathologic process, is increasingly involved with a series of diseases such as central obesity and diabetes. Hypertension is highly associated with IR. The relationships between IR and glucose or lipid metabolism disorders are well established. However, association of IR with hypertension is less covered. Current researches on insulin resistance and pathogenesis of hypertension are reviewed in this paper, which holds that traditional Chinese medicine treatment on IR in patients with hypertension has a good prospect.

To evaluate the effectiveness of applying visual electrophysiological examination, including flash visual evoked potentials ( FVEP ) , flash electroretinogram ( FERG ) , pattrn electroretinogram ( PERG ) , fundus photography, eye B-type ultrasound, optical coherence tomography ( OCT ) , on visual function assessment and retinal disease detection before cataract surgery. METHODS: Visual elctrophysiological examination, fundus photography, eye B-type ultrasound and OCT were applied in 148 cases ( 196 eyes ) . The positive rate was analyzed according to the results of FVEP, FERG ( or PERG ) , fundus photography, eye B - type ultrasound and OCT.RESULTS: ln 148 cases ( 196 eyes ) , vitreous opacities was showed in 165 eyes ( 84. 2%) by eye B - type ultrasound examination, 31 eyes (15. 8%) without access to B-type ultrasound image; success for fundus camera images in 161 eyes (80. 6%), and unable to get image in 35 eyes (19. 4%); the VEP and ERG in 58 eyes (29. 6%) were get valuable, and the VEP and ERG were saw no obvious abnormal in 138 eyes ( 70. 4%); success for OCT image in 167 eyes (85. 2%), without access to OCT image in 29 eyes (14. 8%). CONCLUSlON: Visual elctrophysiological detection, fundus photography, eye B-type ultrasound and OCT can predict the preoperative visual acuity of cataractous patients. A variety of inspection methods complement each other, can further improve detection rate of retinal diseases and other eye disease before cataract surgery.

Objective To assess the value of high-resolution ultrasonography in diagnosis of cubital tunnel syndrome. Methods Forty-two patients (43 elbows) initially diagnosed as cubital tunnel syndrome underwent ultrasonography (US), while 15 healthy contralateral elbows of these patients taken as self controls, and 15 healthy volunteers as normal controls underwent US of the ulnar nerve. The findings of US measurements were compared with that of intra-operative results and pre-operative electromyography. Results High-resolution US displayed changes and some etiological factors of cubital tunnel syndrome. The measurements of ulnar nerve at the proximal part of the compression were higher than those in the control groups. The cut-off point of cross-sectional area (CSA) and CSA tumefaction ratio was 0.11 cm~2 and 141.50%, respectively. The sensitivity of US was 92.86% compared with intra-operative results, and was 100% when combined with pre-operative electromyography. Conclusion High-frequency ultrasound can be used as an effective method to diagnose cubital tunnel syndrome.

Objective To investigate the changes in the expression of glutamate-aspartste transporter in spinal dorsal horn in rats with inflammatory pain and chronic morphine tolerance. Methods Thirty healthy male SD rats in which intrathecal (IT) catheters were successfully placed without complications were randomized into 3 groups ( n = 10 each): normal saline group ( group NS), arthritis group ( group A), and arthritis + morphine group (group AM). NS 50 μl was injected into the ankle joint of the left hindlimb in group NS, while complete Freund's adjuvant was injected in the other two groups instead. After 3 days, group NS and A received IT NS 10 μl twice a day for 7 consecutive days, group AM IT morphine 10 μg (10 μl) twice a day for 7 consecutive days. Mechanical pain threshold (MPT) was measured before IT administration and at day 2, 4, 6 and 8 after IT administration (T0-4). The animals were sacrificed after the last MPT measurement. The spinal cords were isolated for determination of GLAST expression in spinal dorsal horn. Results Compared with group NS, MPT was significantly decreased in the other groups and GLAST expression was down-regulated in group AM (P ＜ 0.05). Compared with group A, no significant change was found in MPT at T3,4 (P ＞ 0.05), while GLAST expression was down-regulated in group AM ( P ＜ 0.05). Conclusion The development of chronic morphine tolerance is related to the decrease in the function of GLAST in spinal dorsal horn in rats with inflammatory pain.

Objective To analysis the clinical characteristics, treatment and prognosis for patients with cervical cancer with lymph lode of paraaortic and /or supraclavicular metastasis after combined treatment in two years. Methods Data of 20 patients with lymph lode of paraaortic and /or supraclavicular metastasis of cervical cancer were analyzed retrospectively. Results There was no evidence of lymph node of paraaortic and supraclavicular metastasis before the first combined treatments according to the MRI/CT/SPECT scans in these 20 patients. However, lymph lode of paraaortic and/or supraclavicular metastasis were seen in two years after treatments, the shortest is two months. One patient was progressing during treatment whose pathologic diagnosis is mucinous adenocarcinoma, died in 6 months from treatment start. There was only paraaortic metastasis in 15 patients, among these, 4 patients were found lymph lode of left supraclavical metastasis after retreatments in 3-6 months. Both paraaortic and left-supraclavical lymph node metastasis in 4 cases. Among these 20 cases, recurrence and to give up treatment, whose median survival time is 7.50 months, recurrence and to gain treatment, whose median survival time is 18.98 months, there was significant difference (x2=7.23, P<0.01). Conclusion Patients with cervical cancer with lymph lode of paraaortic and/or supraclavicular metastasis after combined treatment will obviously extend survival time after retretments, which has positive therapy significance.

Objective To study the molecular mechanisms of hepatoeyte regeneration following different cold preservation (CP) durations after rat partial liver transplantation. Methods Mate inbred Lewis rats were used as donors and recipients. Donor liver was kept in 4℃ UW solution for 1 h (coldisehemia 1 h group, CI 1 h group), 8 h (CI 8 h group) and 16 h (CI 16 h group) and then implantedorthotopieally. 50% liver graft transplantation model was established by ligating the left portion ofmedian lobe, left lateral lobe and caudate lobe with 3-O silk suture prior to reperfusion. Survival rate ofeach group and hepatoeyte regeneration were recorded after grafting. Reverse transcription-polymerasechain reaction was used to detect the expression of IL-6 and TNF-α in the liver tissues. Western blotanalysis was done to measure STAT3 activation in the liver. Immunohistoehemistry was conducted toanalyze the expression of cyclin D1 and hepatocyte replication with BrdU uptake in the graft. ResultsOperative success rate in all groups was 100%. Compared with CI 1 h group, the TNF-α and IL-6expression (F=67.45 for TNF-a comparison, P<0.05 and F=287.73 for IL-6 comparison,P<0.05 respectively) in 8 h CI and 16 h CI groups was markedly increased after partial grafttransplantation. STAT3 activity in 8 h C1 and 16 h C1 groups was also significantly increased ascompared with that in 1 h CI group. Cyclin D1 expression in 8 CI group was demonstrated withcytoplasmic and nuclear staining at 24 h after transplantation. Grafts in 16 h CI group showed largeareas with no cyclin D1 expression. Number of hepatocytes with BrdU positively stained neclei in 8 hCI group was more than that in 16 h C1 group at 24 h after transplantation (t=19.40, P<0.05).Conclusion Hepatocytes regeneration was present following rat partial transplantation in the graftspreserved for limited time, which may be regulated by TNF-α/IL-6' STAT3/ Cyelin D1/DNAsynthesis pathways; Hepatocytes could not respond to early signals for liver graft regeneration when50%liver graft preserved for 16 h.

Objective To explore the microsurgical techniques in establishing an orthotopic rat liver transplantation model of 20% small-for-size graft. Methods A rat liver transplantation model of 20% small-for-size liver graft was orthotopically performed. Forty male Lewis rats were used as 20 donors and 20 recipients. Donor liver was perfused with 4℃ UW solution via donor portal vein. Su-prahepatic inferior vena cava was anastomosed end-to-end with running suture. Infrahepatic inferior vena cava and portal vein were reconstructed by cuff technique. A sleeve anastomosis for hepatic artery was used. Continuity of the bile duct was established with an end-to-end intraluminal stent. Survival rate of the recipients was recorded and immunohistochemical analysis of hepatocyte replication con-firmed by bromodeoxyuridine (BrdU) uptake. Results Totally 20 liver transplantations of 20% par-tial liver graft were successfully performed. The successful rate of the operation was 100%. Survival rate of the recipients with 20% liver grafts was 93.8% (＞14 d). Histological examination showed normal liver structure with limited injury after transplantation. The number of positively stained nuclei was significantly increased at 72 h after transplantation. Conclusion The 20Z% small-for-size liver grafts initiate and complete the process of liver regeneration after transplantation. Skillful microsur-gery is the key to success of the transplantation model. The stable model is suitable for basic research in partial liver transplantation.

Objective To explore the role of excitatory amino acid carrier 1 (EAAC1)in dorsal root ganglion (DRG) in the mechanism of developing morphine tolerance. Methods Thirty male SD rats were implanted intrathecal catheters and randomized into 6 groups with 5 rats each. The rats of 4 groups were made into the model of adjuvant-induced arthritis in the left hind limb and were administered intrathecally, morphine 10 μg(group M_(10)), morphine 20μg(group M_(20)), morphine 20 μg plus naloxone 10 μg(group MN) ,or saline(group C) respectively. The other 2 groups without were administered intrathecally saline (group C_0) or morphine 20 μg (group M0). The drugs were administered twice daily for 7 days. Mechanical withdrawl threshold(MWT) of the left hind limb was examined to evaluate the behavior. Immunohistochemistry was used to detect the expression of EAAC1 in the left L_(3-4) and L_(4-5) DRG. Results Morphine tolerance was formmed stably in the arthritis rats of group M_(10) and group M_(20) after administering morphine for 7 days. The expression of EAAC1 in DRG was downregulated. Conclusion DRG EAAC1 may be involved in the mechanism of developing morphine tolerance in rats with inflammatory pain.

Objective To discover and certify the minimum required months of IQC ( Internal Quality Control ) data which were used to quantify the imprecision To identify the impact of test items , different concentrantions and years on the defective rate .Methods IQC data involving 20 analysis items ( including Albumin, Creatine kinase, Total bilirubin, Alanine aminotransferase, Aspartate aminotransferase, Lactate dehydrogenase,γ-Glutamyl transferase, Alkaline phosphatase, Calcium, Chlorine, Creatinine, Glucose, Potassium, Sodium, Phosphorus, Triglyceride, Total cholesterol, Total protein, Uric acid, Urea) and six measurement systems (including Roche, Architect, Hitachi, Dade/Behring, Beckman, Olympus) were collected from hospitals in Shanghaibetween 2009 and 2011.A total of 3 534 groups, referred to one year laboratory′s IQC data of one concentration range , were analysed to find the minimum required months in each group when the cumulative months were compared with the population by using T test.The correlation coefficient of hospital′grades, measurement levels and test items were evaluated by u test, and the percentage of groups of P>0.05 were collected.The cumulative IQC data′coefficient variation ( CV) of six months and eleven months were compared with the total CV, respectively .Imprecision higher than the professional specification was regarded as unqualified .Difference of unqualified rate among test items, concentrations and years were expolored .Results Rates of hospital′grades, measurement levels , items are 94.2%,100%, 100%respectively , 88%of groups′imprecision became stable in ten months .25%groups reach the criteria that the relative bias is ≤5% when calculated the cumulative IQC data′CV of six months, while 88%groups do when calculated the cumulative IQC data′CV of ten months.The unqualified rate is 20%and the most unqualified item is Ca , the unqualified groups of low level are larger .With increase of year , the unqualified rate showed a downtrend .Conclusions Ten months′IQC data is more reliable to quantify imprecision .Unqualified rates are different according to test items , measure levels and years , the establishment of professional specification should consider them.

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