The changes of plasma myostatin levels in patients with type 2 diabetes mellitus (T2D) and their clinical correlation were investigated. We recruited 43 T2D patients and 20 age-matched healthy subjects. Plasma myostatin, lipid and glucose, and serum insulin were determined. T2D patients showed significantly higher fasting plasma glucose (FPG), serum insulin and triglyceride levels, and lower high-density lipoprotein levels than normal control subjects (P<0.01). Mean plasma myostatin level in T2D patients and health controls was (66.5±17.8) and (46.2±13.8) ng/mL, respectively. An unpaired t test showed that the increase of myostatin in the T2D patients was significant (P<0.001). In both healthy control and T2D groups, the female subjects showed higher myostatin levels than the male subjects. In the T2D patients, plasma level of myostatin was negatively correlated with body mass index (BMI, r=-0.42, P<0.01) and FPG (r=-0.51, P[Symbol: see text]0.01), but positively correlated with insulin resistance index (HOMA-IR, r=0.48, P<0.01). Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI, FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease. Furthermore, circulating myostatin levels may be used as a biomarker for the disease.

Recombinant Fl-V (rFl-V) fusion protein is the main ingredient of the current candidate vaccine against Yersinia pestis infection, which has been under investigation in clinical trial in USA. We investigated the soluble expression conditions of rF1-V in Escherichia coli BL21 (DE3) that we constructed before. After scale-up and optimization of fermentation processes, we got the optimized fermentation process parameters: the culture was induced at the middle exponential phase with 50 µmol/L of IPTG at 25 °C for 5 h. Soluble rFl-V protein was isolated to 99% purity by ammonium sulfate precipitation, ion exchange chromatography, hydrophobic chromatography and gel filter chromatography. The protein recovery was above 20%. Protein identity and primary structure were verified by mass spectrometry and Edman sequencing. Results of purity, quality and western blotting analysis indicated that the target protein is a consistent and properly folded product. Furthermore, the immunogenicity of various antigens formulated with aluminum hydroxide adjuvant was evaluated in mice. Serum antibody titers of 4 groups including 20 µg rFl, rV and rFl-V and 10 µg rFl+10 µg rV, were assayed by ELISA after 2 doses. The antibody titers of anti-Fl with 20 µg rFl-V were obviously higher than titers with other groups; meanwhile there were no significant difference of anti-V antibody titers among them. These findings confirm that rFl-V would be the active pharmaceutical ingredient of the plague subunit vaccine.
Adjuvants, Immunologic ; Animals ; Antibodies, Bacterial ; blood ; Antibody Formation ; Antigens, Bacterial ; immunology ; Blotting, Western ; Chromatography, Ion Exchange ; Enzyme-Linked Immunosorbent Assay ; Mice ; Plague ; prevention & control ; Plague Vaccine ; immunology ; Recombinant Fusion Proteins ; immunology ; Vaccines, Subunit ; immunology ; Yersinia pestis

OBJECTIVE:To establish a method for the content determination of carbohydrates in Osseous and cucumis extract injection. METHODS:Ion chromatography was conducted on the column of Dionex CarboPac PA20 with mobile phase of water-1 mol/L Sodium acetate solution-250 mmol/L Sodium hydroxide solution(gradient elution)at flow rate of 0.45 ml/min,column tem-perature was 35 ℃,and injection volume was 10 μl,detector was electrochemical analysis detector. RESULTS:The linear ranges of galactose,glucose,mannose,sucrose and fructose were 0.5-10.0μg/ml(r>0.998 0);RSDs of precision,stability and reproduc-ibility tests were lower than 2%;recovery was 94.8%-99.1%(RSD=0.52%-0.89%,n=9). CONCLUSIONS:The method is sim-ple,fast and accurate,and can be used for the determination of carbohydrates in Osseous and cucumis extract injection.

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus (T2D) and their clinical correlation were investigated. We recruited 43 T2D patients and 20 age-matched healthy subjects. Plasma myostatin, lipid and glucose, and serum insulin were determined. T2D patients showed significantly higher fasting plasma glucose (FPG), serum insulin and triglyceride levels, and lower high-density lipoprotein levels than normal control subjects (P<0.01). Mean plasma myostatin level in T2D patients and health controls was (66.5±17.8) and (46.2±13.8) ng/mL, respectively. An unpaired t test showed that the increase of myostatin in the T2D patients was significant (P<0.001). In both healthy control and T2D groups, the female subjects showed higher myostatin levels than the male subjects. In the T2D patients, plasma level of myostatin was negatively correlated with body mass index (BMI, r=-0.42, P<0.01) and FPG (r=-0.51, P[Symbol: see text]0.01), but positively correlated with insulin resistance index (HOMA-IR, r=0.48, P<0.01). Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI, FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease. Furthermore, circulating myostatin levels may be used as a biomarker for the disease.
Blood Glucose ; Diabetes Mellitus, Type 2 ; blood ; Female ; Humans ; Insulin ; blood ; Lipids ; blood ; Male ; Middle Aged ; Myostatin ; blood

Objective To explore the effect of Ai'er health exercise in patients with chronic heart failure.Methods A total of 110 hospitalized patients with chronic heart failure were randomly divided into Ai'er health exercise group and control group, with 55 cases in each group. The patients of control group were given routine treatment and nursing, patients in Ai'er health exercise group were given Ai'er health exercise based on the control group treatment and nursing method. The cardiac function classification, cardiac function index, 6 min walking test, 6 months after discharge and the rate of hospitalization and mortality were compared between two groups before and after the intervention.Results After the intervention, heart function index of the two groups of patients were significantly improved, and the differences were statistically significant (P<0.05). The degree of the heart function index of the health of Ai'er exercise group was significantly better than that of the control group, and the difference was statistically significant (P<0.05). After the intervention, the health of Ai'er exercise group for 6 min walking test distance were (220.8±13.5)m which was significantly longer than that in the control group (153.4±9.7)m, and the difference was statistically significant(t=3.139,P<0.05). Ai'er health exercise patients were discharged after 6 months of hospitalization was 7.3% which was lower than that in the control group 21.8%, and the difference was statistically significant (P<0.05); the mortality rate of two patients discharged from 6 months had no significant difference (P>0.05).Conclusions Ai'er health exercise can significantly improve the heart function index in hospitalized patients with chronic heart failure, improve exercise capacity, and reduce readmission rate.

Alzheimer's disease (AD) is one of the major diseases that harmful to healthy elderly, and mild cognitive impairment (MCI) is the early clinical stage of AD. There is a lag in the clinical diagnosis of both diseases. An objective and reliable auxiliary diagnostic method is urgently needed to provide early diagnosis and differential indicators for AD and MCI, to predict the probability of individuals suffering from AD and MCI transforming into AD, and to reduce the overall incidence of AD and reduce the huge medical and economic burden for the country and society. Event-related potential is widely used in AD and MCI, and the resolution at the millisecond level can truly reflect the time course of cognitive processing and the degree of impairment of cognitive function in patients. In this study, we investigated the differences in the amplitude and latency of ERP components in healthy elderly, MCI and AD patients, and the correlation between ERP components and cognitive impairment. Early N170 and P200 showed high sensitivity and specificity in differentiating MCI from healthy elderly or MCI from AD. The late perception-related ERPs also showed high sensitivity and specificity in differentiating healthy elderly from MCI/AD. The differences in ERPs between MCI and AD may be related to the etiology, the degree of disease progression and the site of brain damage. The specific brain mechanism still need to be further explored and will be the focus of future research. With the progress of the research, the relationship between the specific ERP manifestations and the mechanism of brain injury as well as the impairment of cognitive function will be more clear. It is believed that the application of ERP in clinical will bring more benefits to AD and its early clinical MCI.

Objective To investigate the relationship between systemic immune-inflammation index(SII),red blood cell distribution width(RDW),albumin(ALB)ratio(RAR)and severity of disease and respiratory failure in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 110 patients with AECOPD were divided into the severe group(n=37)and the non-severe group(n=73).They were also divided into the respiratory failure group(n=26)and the non-respiratory failure group(n=84)according to whether they had respiratory failure.Platelet count(PLT),neutrophil count(NEU),lymphocyte count(LYM),RDW,ALB,SII and RAR were compared between different groups.Multiple Logistic regression method was used to analyze influencing factors of severe and concurrent respiratory failure.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of indicators for severe condition and respiratory failure.Results Compared with the non-severe group,there were increased NEU,SII,RDW and RAR,and decreased PLT and LYM in the severe group(P＜0.05).Compared with the non-respiratory failure group,there were increased NEU,SII,RDW and RAR,and decreased LYM and ALB in the respiratory failure group(P＜0.05).Multivariate Logistic regression analysis showed that increased SII and RAR were independent risk factors for severe condition or respiratory failure in patients with AECOPD.ROC curves indicated that the area under the curve(AUC)of SII combined with RAR for predicting severe condition and respiratory failure in patients with AECOPD were 0.882(0.806-0.935)and 0.908(0.837-0.954),both of which were higher than those of SII or RAR alone(P＜0.05).Conclusion Combination of SII and RAR can effectively help to evaluate the condition and the occurrence of respiratory failure in patients with AECOPD.

Objective:To investigate the relationship between lexical semantic processing abnormalities and cognitive function and clinical symptoms in schizophrenia based on the activation diffusion model and semantic distance.Methods:All subjects matched with demographic data were randomly divided into experiment group( n=27) and control group( n=30). The semantic distance of words of different semantic categories and lexical categories were assigned at a level of 1-7.The semantic distance between the two groups was analyzed by repeated measures of variance, and the correlation analysis was conducted on the scores of the MATRICS Consensus Cognitive Battery (MCCB) and positive and negative syndrome scale (PANSS) in the experimental group. Results:The main effects of the groups in semantic distance were statistically significant( F(1, 55)=7.460, P=0.008, ηp2=0.981). The semantic distance in the experimental group (3.672±0.105)was lower than that in the control group (4.068±0.100). The main effect of the semantic category was statistically significant( F(1, 55)= 833.37, P<0.01, ηp2=0.938), and the semantic distance in the relative condition (1.965±0.074) was lower than that in the unrelative condition(5.775±0.117). Under the relative condition, concrete semantic deviation was negatively correlated with the total score of MCCB( r=-0.405, P=0.036)and speech learning ( r=-0.569, P=0.002). Abstract semantic deviation was negatively correlated with speech learning( r=-0.429, P=0.026). Under the unrelative condition, concrete semantic deviation was negatively correlated with MCCB total score ( r=-0.597, P=0.001), speech learning( r=-0.399, P=0.039)and other dimensions.Abstract semantic deviation was negatively correlated with MCCB total score( r=-0.593, P=0.001) and speech learning( r=-0.285, P=0.050). Under the relative condition, the abstract semantic deviation was positively correlated with the general symptom scale score( r=0.448, P=0.019). Under the unrelative condition, abstract vocabulary semantic deviation was positively correlated with PANSS total score( r=0.120, P=0.010), negative scale score( r=0.047, P=0.030) and general symptom scale score ( r=0.306, P=0.010). Conclusion:The semantic distance of lexical processing is abnormal in schizophrenia. The semantic deviation is related to the cognitive function index and symptom index.

Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.