Objective To assess clinical results between proximal-first sequential anastomosis technique (POPCAB) and conventional technique off-pump coronary artery bypass grafting(COPCAB) in 72 patients over 65 years old.Methods Between Jan 2008 and Oct 2012,72 patients with multiple vessel coronary artery disease underwent off-pump coronary artery bypass grofting.They were divided into two groups,POPCAB and COPCAB groups.Preoperative and postoperative variables of two groups were compared.Results There were no significant difference in sex,age,history of acute myocardium infarction,hypertension,diabetes and number of bypass grafts between two groups.The ICU stay time in POPCAB group was less than in COPCAB group(P ＜0.05).There were lower creatine kinase MB and cardiac trop I after operation in POPCAB group compared with COPCAB group(P ＜ 0.05).Conclusion The results confirm that promixal-first sequential anastomosis technique remains a valuable option of surgical myocardial revascularization,and may optimize the outcome in the aged.

The paper is a report of sociological investigation about thousands of peoples who were exposed to acute infection of schistosomiasis in subdistrict Younyuan, Wuhan City. 9 organizations, 258 families (944 persons) were surveyed with sociological metheds such as outlined questionare, personal questioning, visit and meeting. The result showed that some factors (age, profession, cultural level, size of residing place, distance between residing place and Yangtze river, frequency of swimming in river) were closely related with the epidemic outbreak of acute schistosomiasis. Thus we suggest that public health education should be implemented as an important antischistcsomiasis measure for local residents in urban epidemic areas when snail host (Oncomelania hupensis) of Schistosoma japonicum has not been controlled.

Objective To observe the contents of acid phosphatase (ACP) of Oncomelania snails infected with Schistosma japonicum.Methods Both the blood lymphocytes of positive and negative Oncomelania snails were dyed with the histochemistry staining method and their ACPs were observed under a microscope. Results The contents of ACP in the positive Oncomelania snails increased, being significantly higher than those in the negative snails. Conclusion The contents of ACP increase in Oncomelania snails infected with Schistosoma japonicum and ACP may have the defence function.

Objective To understand the moving patterns of Oncomelania snails, intermediate host of S.japonicum, in the water bodies. . Methods. Based on the biological features of the snails, methods and techniques in relation to hydraulics and silt engineering were adopted to investigate the active scrawl ability and passive movement of the snails. . Results and Conclusion . The scrawl speed of the snails themselves was very low, 2.^45 mm per minute only. The active movement in the water current was therefore almost negligible. The major moving patterns of the snails in rivers and canals were that: 1. Snails adsorbed on different kinds of carriers drifted on the water. 2. Snails suspended on the water and drifted with the current, these were the young snails under 7 weeks of age. Adult snail showed a strong ability of adhesion, 12 times higher than its body weight.

Objective:To observe the relationship between the different stages of type 2 diabetes mellitus(T2DM)and the intestinal flora and verify its underlying mechanism.Methods:T2DM rats were generated by high-fat diet(HFD)combined with intraperitoneal streptozo-tocin(STZ)injection.The rats were divided into four groups:the control group(fed with normal feed for 1 month),the HFD group(fed with HFD for 1 month),the T2DM group(HFD combined with STZ and blood glucose＞11.1 mM),and the unformed T2DM model(Un-mod)group(HFD combined with STZ and blood glucose＜11.1 mM).Feces were collected,and bacterial communities in the fecal samples were analyzed by 16S rRNA gene sequencing.The content of short-chain fatty acids(SCFAs)in feces was measured by gas chromatography.Western blot and quantitative real-time polymerase chain reaction were used to detect the expression of G protein-coupled receptor 41(GPR41)and GPR43.Results:At different stages of T2DM,the intestinal flora and SCFAs content of rats were significantly decreased(all P＜.05).Our results indicated that g_Prevotella had a significant negative correlation,and g_Ruminococcus_torques_group and g_lachnoclastic had a significant positive correlation with blood glucose.The content of SCFAs,in particular acetate and butyrate,in rat feces of different stages of T2DM were significantly reduced,as well as GPR41 and GPR43 expression.The results in the Un-mod group were similar to the T2DM group,and the expression of GPR41 and GPR43 proteins were significantly higher than those in the T2DM group(both P＜.001).Conclusion:The intestinal flora-SCFAs-GPR41/GPR43 network may be important in the development of T2DM.Decreasing blood glucose levels by regulating the intestinal flora may become a new therapeutic strategy for T2DM,which has very important clinical and social values.

Objective To investigate the impact of various distribution of bone cement on the early clinical outcomes in osteoporotic vertebral compression fracture (OVCF) patients treated with percutaneous kyphoplasty (PKP).Methods A total of 312 patients (54 males and 258 females,mean age 69.37 years) who diagnosed as OVCF and received PKP treatment from January 2015 to July 2017 were enrolled in the present study.All subjects were divided into two groups according to different distribution of bone cement:the shaped "O" distribution (group O,113 cases),in which bone cement in the vertebral body presented whole crumb,no separation or loss of bone cement,and the shaped "H" distribution (group H,199 cases),in which bone cement in the vertebral body presented two briquettes,connected with or without a small amount of bone cement.Demographic data,surgical details,radiographic data,and clinical outcomes (at preoperatively,two-days and one-year follow-up) were compared between the two groups.Results There was no significant difference in bone mineral density (BMD),operation duration,blood loss,and occurrence of leakage of bone cement between two groups.In comparison with group O,group H was accompanied with higher volume of injected bone cement and higher proportion of bilateral approach (P＜0.05).Both groups achieved significant improvement of VAS scores after surgery,while the group H had a dramatical reduction of VAS scores at one-year follow-up compared with two-days follow-up (P＜0.05).In addition,group H had a better restoration of VAS scores at one-year follow-up than group O (P＜0.05),though no significant difference was observed at preoperative and two-days follow-up.Both groups achieved significant improvement of radiographic data after surgery (P＜0.05) with similar effects of correction.Conclusion Either shaped "H" or shaped"O" distribution of bone cement can obtain satisfied early clinical effects of PKP for the treatment of OVCF.Compared with shaped "O" distribution,shaped "H" distribution can achieve better pain relief at early follow-up.

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease caused by inflammatory cells. Various inflammatory cells involved in RA include fibroblast-like synoviocytes, macrophages, CD4⁺T-lymphocytes, B lymphocytes, osteoclasts and chondrocytes. The close interaction between various inflammatory cells leads to imbalance of immune response and disorder of the expression of mRNA in inflammatory cells. It helps to drive production of pro-inflammatory cytokines and stimulate specific antigen-specific T- and B-lymphocytes to produce autoantibodies which is an important pathogenic factor for RA. Competing endogenous RNA (ceRNA) can regulate the expression of mRNA by competitively binding to miRNA. The related ceRNA network is a new regulatory mechanism for RNA interaction. It has been found to be involved in the regulation of abnormal biological processes such as proliferation, apoptosis, invasion and release of inflammatory factors of RA inflammatory cells. Understanding the ceRNA network in 6 kinds of RA common inflammatory cells provides a new idea for further elucidating the pathogenesis of RA, and provides a theoretical basis for the discovery of new biomarkers and effective therapeutic targets.
Humans ; Arthritis, Rheumatoid/genetics* ; MicroRNAs/metabolism* ; Synoviocytes/pathology* ; Cytokines/metabolism* ; RNA, Messenger/metabolism* ; Fibroblasts/pathology* ; Cell Proliferation

ObjectiveTo observe the effect of water extract of Mori Folium （MLE） on oxidative stress in adipose tissue of type 2 diabetes mellitus （T2DM） mice and explore its mechanism. MethodTwenty-four male db/db mice were randomly divided into model group， metformin group， low-dose MLE （MLE-L） group， and high-dose MLE （MLE-H） group according to their body weight and blood glucose， with six mice in each group， and other six C57BLKS/JGpt wild littermate mice were selected as normal group. The mice in the metformin group were given 200 mg·kg^-1 metformin suspension， and the mice in the MLE-L and MLE-H groups were respectively given 2 g·kg^-1 and 4 g·kg^-1 MLE， while the mice in the normal group and model group were given the same dose of deionized water by daily gavage for eight weeks. Body weight， subcutaneous fat index， fasting blood glucose （FBG）， and oral glucose tolerance level （OGTT） of the mice were detected， and serum superoxide dismutase （SOD）， glutathione peroxidase （GSH-Px）， and malondialdehyde （MDA） were measured. The expression levels of silent information regulator 1 （SIRT1） and NADPH oxidase type 4 （NOX4） protein in subcutaneous adipose tissue of the mice were detected by Western blot. ResultThe FBG level， OGTT， and subcutaneous fat index of T2DM mice were significantly decreased （P<0.05， P<0.01） after administration of MLE compared with the blank group. The contents of serum SOD and GSH were significantly increased， while the level of oxidative stress damage marker MDA was significantly decreased （P<0.05， P<0.01）. The expression of SIRT1 protein in adipose tissue was significantly increased， while the expression of NOX4 protein was significantly decreased （P<0.05， P<0.01）. ConclusionMLE can ameliorate T2DM by alleviating oxidative stress in adipose tissue of T2DM mice and reducing blood glucose.

ObjectiveTo investigate the protective effects of Mori Folium extract （MLE） on the kidney of db/db diabetic mice and its mechanism. MethodTwenty-four male C57BLKS/JGpt-Leprdb/Leprdb （db/db） mice were randomly divided into model group， metformin group， low-dose group of MLE （MLE-L）， and high-dose group of MLE （MLE-H） according to their fasting blood glucose （FBG）， with six mice in each group， and other six C57BLKS/JGpt wild littermate （m/m） mice were selected as normal group. The mice in the drug administration groups were given corresponding drugs by gavage， and the mice in the normal group and model group were given the same dose of deionized water by gavage once a day for continuous eight weeks. Body weight， bilateral kidney weight， and FBG were measured， and an oral glucose tolerance test （OGTT） was performed. The pathological changes in the kidney tissue of mice were observed by hematoxylin-eosin （HE） and periodic acid-silver （PAS） staining， and serum creatinine （SCr） and blood urea nitrogen （BUN） levels were detected. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of tumor necrosis factor-alpha （TNF-α） and interleukin-6 （IL-6） in serum and urinary microalbumin （U-mAlb） of mice. The expression levels of toll-like receptor 4 （TLR4）， myeloid differentiation factor 88 （MyD88）， and nuclear factor-kappa B p65 （NF-κB p65） protein in kidney tissue of mice were tested by Western blot. ResultCompared with the normal group， the body weight， absolute renal weight， FBG， and the area under the curve （AUC） of OGTT of mice in the model group were significantly increased （P<0.01）， and the levels of SCr， BUN， and U-mAlb， as well as TNF-α and IL-6 in serum were significantly increased （P<0.01）. The glomerular basement membrane in the kidney tissue of mice was thicker， with obvious inflammatory cell infiltration. The protein expression levels of TLR4， MyD88， and NF-κB p65 in the kidney tissue of mice were increased significantly （P<0.01）. Compared with the model group， there was no statistical difference in the body weight of mice in each drug administration group. The absolute renal weight of mice in the MLE-H and metformin groups was significantly reduced （P<0.05， P<0.01）. The FBG levels of mice in the metformin， MLE-L， and MLE-H groups started to decrease after treatment for four to eight weeks （P<0.05， P<0.01）. The AUC of mice in the MLE-H and metformin groups was significantly decreased （P<0.01）. The levels of SCr， BUN， and U-mAlb of mice in the MLE-H and metformin groups were significantly decreased （P<0.01）， and those of SCr and U-mAlb of mice in the MLE-L group were significantly decreased （P<0.01）. The levels of TNF-α and IL-6 in the serum of mice in the MLE-H and metformin groups were significantly decreased （P<0.01）. The renal tissue pathology of mice in each drug administration group was improved to varying degrees， and the protein expression levels of TLR4， MyD88， and NF-κB p65 in the MLE-H group were decreased significantly （P<0.05， P<0.01）. ConclusionMLE can improve the renal structure and function of db/db diabetic mice， and its mechanism may be related to the inhibition of the TLR4/MyD88/NF-κB signaling pathway.

Mori Folium， the dried leaves of Morus alba， is widely used in clinical practice for dispersing wind and heat， clearing the lung and moistening dryness， soothing the liver and improving vision， and cooling blood and stopping bleeding. It has been used to regulate blood glucose since ancient times， and modern studies have shown that the active components of Mori Folium for lowering blood glucose mainly include flavonoids， alkaloids， polysaccharides， and phenols. These components are mainly extracted by solvents such as water and alcohols with the assistance of ultrasound and microwave. In addition， new extraction methods are emerging， such as CO₂ supercritical fluid extraction， enzymatic hydrolysis， and cloud point extraction. Mori Folium lowers blood glucose via multiple components， pathways， and targets. Specifically， it can improve glucose and lipid metabolism， protect pancreatic β cells， and alleviate insulin resistance to reduce the damage caused by hyperglycemia and restore normal physiological functions. Although a large number of studies have been carried out on diabetes， the causes and radical treatment methods remain to be explored， and diabetes is still a major disease that endangers human health and needs to be solved urgently. The articles about extraction process and mechanism of active components in Mori Folium for lowering blood glucose were retrieved from the China National Knowledge Infrastructure （CNKI）， Web of Science， and PubMed. We analyzed the applicable extraction methods for the blood glucose-lowering components such as flavonoids， polysaccharides， and alkaloids in Mori Folium， and compared the conventional and emerging methods. Furthermore， we summarized our research achievements in the extraction of active components from Mori Folium and the blood glucose-lowering effect and mechanisms. This review aims to provide theoretical support for the optimization of the extraction process， the research on the blood glucose-lowering components and mechanism， and the development of new drugs and clinical application of Mori Folium.