Insulin resistance is the important base of the pathogenesis of type 2 diabetes.Physical exercise can improve insulin sensitivity.This article presents an overview of how physical exercise improves insulin resistance and helps the prevention and treatment of diabetes mellitus by analyzing its influence on the level of insulin receptor and post-receptor and adipose cell cytokine.

Objective To explore the levels of serum interleukin-6 and interleukin-18 in newly diagnosed type 2 diabetes mellitus (T2DM) and investigate their roles. Methods The serum interleukin-6 and interleukin-18 levels were detected in 50 newly, diagnosed T2DM patients (T2DM group) and 40 normal subjects (control group). Fasting blood glucose, fasting insulin, blood lipid, body mass index (BMI) and waist/hip ratio (WHR) were measured. HOMA-IR and HOMA-β were calculated. Results The serum interleukin-6 and interleukin-18 levels in T2DM group were significantly higher than those in control group [(2.56 ± 1.09) ng/L vs (1.81±0.80) ng/L, (5.38±0.91) ng/L vs (4.62±0.59)ng/L] (P <0.01).Interleukin-6 level was positively correlated with HbA_1c,while interleukin-18 level was positively correlated with BMI and WHR. Interleukin-6 and interleukin-18 levels were positively correlated. Interleukin-6 and interhukin-18 could predicted the insulin resistance. Conclusion Interleukin-6 and interleukin-18 take part in the development of T2DM, and can be related to the insulin resistance.

Objective To observe the effect of paraoxonase 1 (PON1) application of the new method of arylesterase activity in patients with coronary heart disease,analysis of paraoxonase 1 (PON1) of the clinical value of arylesterase activity in the new testing method.Methods From January 2014 to January 2016 in our hospital 86 patients with coronary heart disease as the research object,and then select the healthy people at the same time to the hospital physical examination of 50 as the control group to take the research object,spectrophotometric method for the determination of coronary heart disease patients and control subjects serum PON1 arylesterase activity,PON1 arylesterase activity at the same time with statistics the different degree of coronary heart disease,PON1 arylesterase activity between patients with coronary heart disease and control group comparison study and different severity of coronary heart disease patients,the patients with coronary heart disease PON1 aromatic ester enzyme activity,age,gender,BMI,TC,total cholesterol,low density lipoprotein cholesterol LDL-C and glycerin three greases TG included in the analysis of factors of coronary heart disease multiple linear regression equation,to determine the changes of patients with coronary artery disease by PON1 arylesterase activity,to provide a reference for clinical treatment.Results The activity of PON1 in patients with coronary heart disease was significantly lower than that of the control group,and the difference was statistically significant (P<0.05).Single branch lesions in patients with PON1 arylesterase activity was significantly higher than that of double vessel lesions and three lesions were double branch lesions in patients with PON1 arylesterase activity was significantly higher than that in three patients,the differences were statistically significant (P<0.05).According to the multiple linear regression analysis showed that coronary heart disease and the patient′s age,gender,BMI,TC,LDL-C,TG and PON1 arylesterase activity (P<0.05),which was related with age,gender,BMI,TC,LDL-C and TG were positively correlated,negatively correlated with PON1 arylesterase activity.Conclusion The PON1 activity of in patients with coronary heart disease is significantly decreased,and the extent of the disease is more severe,the more obvious the decline of PON1,the activity of PON1 shows a negative correlation with coronary heart disease.

Objective To investigate the effect of EGB on SOD, MDA of ventilator-induced lung injury in rats and its possible mechanisms. Methods Thirty male SD rats were randomly divided into 3 groups: control group (C group), high tidal ventilation group (H group) and EGB group (E group). The setting mechanical ventilation was VT=30 mL/kg, RR=40/min, I/E=1/3, PEEP=0 cmH2 O and FiO2=21%. The broncho-alveolar lavage fluid (BLAF) and serum were obtained for determination of the levels of SOD and MDA at the end of 4 h mechanical ventilation. The Lungs were removed, and the wet-to-dry weight ratio (W/D) and pulmonary pathologic changes were measured. Results As compared with C group, W/D and the levels of MDA were significantly increased in H group, but the levels of SOD were reduced in H group. As compared with H group, W/D and the levels of MDA were significantly decreased in E group, but the levels of SOD were increased in E group. Pulmonary pathologic changes were alleviated in E group comparing with H group. Conclusion EGB injection may have a protective role against hyperoxia and induced pulmonary damage in rats.

Objective To investigate the classification and treatment of displaced intra articular fractures of the calcaneus. Methods Twelve displaced intra articular fractures of the calcaneus in 8 patients were included in this study. Classification of calcaneus fractures was done according to Sanders' computed tomographic classification system. There were 2 cases of type Ⅱfractures, 4 type Ⅲfractures and 6 type Ⅳfractures. The open reduction and internal fixation (ORIF) and bone grafting were performed using a standard extended lateral approach, and the fractures were fixed with small fragment AO bridge plates with autogenous bone grafting. Average follow up was 28.6 months (range 24 to 33 months). The Creighton Nebraska Health Foundation Assessment Score System for fractures of the calcaneus was used for evaluation. Results The average score was 89.7 for type Ⅱ, 86.5 for type Ⅲ, and 73.5 for type Ⅳfractures. There was statistically significant superiority in treatment by ORIF compared with nonoperative methods (P0.05); whereas in type Ⅳfractures, the differences were significant between with and without bone grafting (P

Objective To discuss diagnostic classification and emergency treatment protocols for complex pelvic fractures. Methods The first aid management of 23 cases of major pelvic fractures were analyzed retrospectively. Results 22 of the patients survived, but one died of hemorrhagic shock.Conclusions Correct classification of severe pelvic fractures is of guidance value to the first aid management. Cooperation among multiple departments, comprehensive application of various surgical methods, early stabilization of hemodynamics, rapid repair of injured organs, stabilization of pelvic ring with external fixator are effective techniques to enhance the survival rate of patients with severe pelvic fractures.

Objective To examine the expression of CGRP in congenital pseudarthrosis of tibia(CPT) in order to find the pathogenesis of CPT.Methods Periosteum and bones from CPT patients were collected as experimental group.Immunohistochemistry stain was applied to determine the differences of the expression of CGRP in two groups.Results CGRP was located at vessel wall of periosteum and intracytoplasm of osteoblasts and osteoclasts in bones,its expression was significantly less in periosteum and bones of CPT than that in control group(P

Objective To assess the reliability and validity of the Somatic Self-rating Scale(SSS). Methods The sample consisted of 589 outpatients and 64 inpatients, which all the patients completed Zung's Scales at the same time to test criterion validity of the SSS. And 24 inpatients were selected randomly to take a retest after two weeks without antidepressant treatment. Result The test-retest reliability of the SSS was 0.96 and the Cronbach' s αcoefficients was 0.89. The correlation coefficients of the four factors with the total scale score ranged from 0.76 to 0.88, the correlation coefficients of the four factors ranged from 0. 56 to 0.70. The confirmatory factor analysis showed that the fit index for GFI, NFI, NNFI, CFI, IFI were all approaching 0.9, REMEA = 0. 064,x2/df = 3.67. The factor loadings ranged from 0. 427 to 0.732. Correlations with Zung's Scales were in range of 0.74to 0. 80 while the four factors were in range of 0.55 to 0.74. Drawing the ROC curve and the area under the curve was 0.841. Conclusion The SSS has a high reliability and a good validity and can be used in general hospital.

Objective To study whether there was significant difference between pregnant women , data and the results of prenatal screening of single intrauterine fetal death ( sIUFD) when twin pregnancy and singleton pregnancy for guiding the clinical prenatal screening and risk consulting .Methods By comparative study, 56 cases of sIUFD when twin pregnancy were recorded from 2011 to 2014 in Ningbo Prenatal Diagnosis Center , all were natural pregnancy , the sistens gestational weeks were less than 14 weeks , and 4 993 natural singleton pregnancy .The pregnant women , data and the results of serological prenatal screening between sIUFD and singleton pregnancy were analyzed by t-test and rank sum test .Separately , the 56 cases of prenatal screening , risk value was calculated according to the twins and singleton , then the difference were analyzed combined with the results of follow-up.Results Pregnant women , data of two groups were analyzed, there were no statistically significant difference between sIUFD and singleton pregnancy .The age of sIUFD and singleton was (27 ±3)year-old and (27 ±3)year-old respectively, t=2.56, P>0.05; the weight of sIUFD and singleton was (55.2 ±10.23 ) kg and (56 ±10.34) kg, t=4.268, P>0.05.The gestational weeks of sIUFD and singleton were (39.21 ±0.78)weeks and (39.1 ±0.91) weeks, t=1.3, P>0.05;the weight of newborn was (3.38 ±0.41) kg and (3.31 ±0.43) kg, t=1.9, P>0.05.The AFP multiple of median (AFPMOM) of sIUFD and singleton was 1.41(0.99,1.83) and 1.02(0.84,1.24), Z=5.337, P<0.05.Free human chorionic gonadotropin beta multiple of median of sIUFD was 1.04(0.62, 1.64) and 0.99(0.67,1.51), Z=0.275, P>0.05;unconjugated estriol multiple of median of sIUFD and singleton was 1(0.79,1.16) and 1.01(0.85,1.21), Z=1.334, P>0.05.Trisomy 21 risk of sIUFD and singleton was 7 750(2 200,28 000) and 5 300(2 000,12 000), Z=2.093, P<0.05, that had significant difference.The 56 cases of prenatal screening risk value was calculated according to the twins and singleton , among whom 42 cases had the same conclusion , 14 cases had the different conclusion .Among them, according to singleton calculation , 3 cases for high risk, according to the twin calculation of high risk for 17 cases,χ2 =12.1, P <0.05.According to follow-up, all newborns were normal.Conclusions For the natural pregnancy , sIUFD when twin pregnancy , if the sistens gestational weeks less than 14 weeks, the risk of prenatal screening results calculated according to singleton will be more reasonable , as for the prenatal screening for twin pregnancy , the method needs further exploration .

Objective To investigate the effects of dihydrofolate reductase (DHFR) gene expression up-regulating on cisplatin resistance in epithelial ovarian cancer cell lines.Methods The cDNA length of DHFR gene was amplified by PCR and was connected to lentiviral vector pWPI, the recombinant retroviral vector DHFR-pWPI was infected SKOV3 cells by lipofectamine 2000.The groups included DHFR-pWPI-SKOV3 cell, pWPI-SKOV3 cell and SKOV3 cell group.Western blot was used to detect the expression of DHFR.Flow cytometry was applied to measure the cell apoptosis rate of 3 groups cells in different cisplatin concentrations (2.5, 5.0, 10.0, 20.0 μg/ml) and at different time period (24, 48 and 72 hours), and half maximal inhibitory concentration (IC50) treated with cisplatin concentration (6.0, 4.0, 4.9 μg/ml).High performance liquid chromatography (HPLC) was applied to test intracellular cisplatin concentration in different cisplatin concentration (4.0, 6.0, 8.0 μg/ml) at 24 and 48 hours.Transmission electron microscope was used to observe ultrastructural changes cells under IC50 cisplatin concentration.Results The recombinant plasmid DHFR-pWPI was constructed and then infected into SKOV3 cell successfully.(1) The expression of DHFR detected by western blot in transfection group was higher than those in the negative control group and blank control group (10.280±0.009 vs 2.050±0.003 vs 3.480±0.003;P＜0.01).(2) Treated with cisplatin concentration (2.5, 5.0, 10.0, 20.0 μg/ml) at 24, 48 hours, the apoptosis rate detected by flow cytometry results shown that they were lower than those in the negative control group and blank control group (P＜0.05), while treated at the concentration of 5.0 and 10.0 μg/ml for 72 hours, whose apoptosis rate in transfection group was higher than those in the negative control group and blank control group (P＜0.05).When treated cells under IC50 cisplatin concentration (6.0, 4.0, 4.9 μg/ml) at for 24 and 48 hours, the results indicated thatthere were mainly G0/G1 stage cell cycle rate in 3 groups, it was obviously higher in transfection group than those in two control groups (P＜0.05).However, mainly G2/M, S stage cell cycle rate for 72 hours, and S stage cell cycle rate in transfection group obviously higher than those in two control groups, but G2/M stage cell cycle rate were lower (P＜0.01).(3) After treated with cisplatin concentration (4.0 μg/ml) for 24, 48 hours and cisplatin concentration (6.0 μg/ml) for 24 hours, the intracellular cisplatin content tested by HPLC method in the transfection group were significantly lower than those in two control groups (P＜0.01).While, at 6.0 μg/ml of cisplatin concentration for 48 hours and 8.0 μg/ml of cisplatin concentration for 24 and 48 hours, the intracellular cisplatin content of transfection group were obviously higher than those two control groups (P＜0.05).(4) Treated with IC50 (6.0, 4.0, 4.9 μg/ml) cisplatin concentration at different time to obeserve ultrastructural changes by transmission electron microscopy.The results shown that the microwire gathered together at 24 and 48 hours, and the number and structure of mitochondria had obvious change in transfection group, while there was rare microfilament, the number of mitochondria decreased but structure change was not apparent in two control groups.There were appeared expansion of endoplasmic reticulum and had rare normal organelles among three groups.After treated with cisplatin for 72 hours, there were inordinate microfilament, a part of nuclear membrane disappeared, a lot of ribosomes gathered together in two control groups, and there were rare microfilament in transfection group, nuclear membrane completely disappeared, many white cystic matter were seen in cytoplasm, mitochondrial structure disappeared completely, which seems most cells on the verge of death.Conclusion The lentiviral expressing vector harboring human DHFR gene were successfully constructed.When the up-expression of DHFR gene, the drug-resistant in ovarian cancer cell may be increase, which suggest that there were certain contact between resistance increases with microfilament gathered and the change of the mitochondria.