Animals ; Diabetic Nephropathies ; drug therapy ; Dioscorea ; chemistry ; Polysaccharides ; pharmacology ; Rats

Objective To evaluate the relationship of serum cystatin C (Cys C) levels and the severity of coronary artery diseases (CAD).Methods A total of 194 patients underwent coronary angiography were divided into two groups (102 CAD patients) and control group (non-CAD group,92 cases).To study the relationship of the level of serum cystatin C and the severity of CAD,the serum cystatin C of all enrolled patients was detected by immune-enhancing latex turbidimetry and the serum cystatin C level of CAD group was compared to control group.Results The serum levels of cystatin C of CAD were significantly higher than the control group (P ＜ 0.05).With the increased levels of serum Cys C,CAD severity average score was increased; logistic regression analysis showed that Cys C was one of the risk factors of CAD.Cystatin C concentration was significantly correlated with CAD severity score.A cut-off value of 0.79 mg/L for cystatin C predicted incident CAD with a sensitivity of 76.60％ and specificity of 82.60％,respectively.Conclusions Serum Cys C levels are valuable clinical predictors and closely related to CAD.With the increasing levels of serum Cys C,CAD becomes more severe.

Hypoxia inducible factor (HIF-1α) is a hypoxia response regulator,which is highly expressed in malignant tumors.Researches have shown that HIF-1α plays an important role in epithelial mesenchymal transformation.It can regulate epithelial mesenchymal transition through a series of signal pathways and mechanisms at many levels,to participate in the invasion and metastasis of tumors.To explore the mechanism of HIF-lα controlling epithelial mesenchymal transformation has important significance for the development of new,effective tumor treatment methods.

OBJECTIVE:To establish an HPLC method for the assaying of silybin in Gantai capsule.METHODS:The assay was performed on Diamonsil C18 column.The mobile phase consisted of potassium dihydrogen phosphate solution-methanol(45:55)with a flow rate at 1.0ml/min,detection wavelength at 288nm,column temperature at(25?2)℃.The sample size was 20?l and the internal standard was kaempferol.RESULTS:There was a good linear relationship within the concentration range of 0.126～1.26 mg/ml(r=0.9 998)for silybin.The average recovery was 102.9%(RSD=1.50%).CONCLUSION:The method was simple,accurate and reproducible,and suitable for the assaying of silybin in Gantai capsule.

Objective To improve the corrected results of the nasal deformities of the hare lip nose. Methods Based on the reposition of the lower lateral cartilages and the caudal septum, the authors corrected the secondary hare lip nose with the L shaped silicon rubber graft to reinforce and model the nasal tip.Results From 1996～2000, the procedure was performed for 20 cases (15 male, 5 female ), aged from 16～21 years. Follow up was from 3 months to 4 years. All cases obtained satisfactory results. Conclusions The results of utilizing L shaped silicon rubber graft combined with reposition of the mislocated nasal cartilages are better than the latter method only, especialy for the nasal tip. The procedure is easy to learn .The material silicon rubber graft is cheap and can be trimmed very conveniently. And it can also correct the saddle nose at the same time.

Estimation of postmortem interval(PMI) by ocular tissues has been a new top subject in the forensic research and practice ifelds. A lot of research results showed that the changes of cornea, retina, vitreous humor and aqueous humor and so on exist a high linear correlation with PMI, which can be used to estimate PMI. This paper reviewed recent progress of study on them.

Objective To evaluate the combination of the mortality in emergency department sepsis (MEDS) score with blood lactate level in the risk stratification of patients with severe sepsis in the emergency department (ED).Methods 665 adult patients with severe sepsis admitted from May 2011 to December 2012 in ED were found to be eligible for the study.MEDS score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,and arterial blood lactate was determined,and the outcomes in 28 days were recorded.Logistic regression analysis was used to evaluate the relationship between each predictive factor score and prognosis.Each predictive factor was compared with the areas under the receiver operating characteristics (ROC) curve (AUC).Results The mortality in 28 days was 34.6％ in 665 patients.The mortality in group of MEDS score 12-27 was significantly higher than that group of MEDS score＜12 [51.0％ (156/306) vs.20.6％ (74/155),x2=28.414,P=0.000].In the meantime,APACHE Ⅱ score and blood lactate level were also significantly higher in group of MEDS score 12-27 than those in group with MEDS score＜12 [APACHE Ⅱ score:26.4 ± 10.6 vs.21.7 ± 8.1,t=-3.555,P=0.002; lactate (mmol/L):4.9 (2.3,9.9)vs.3.9 (1.5,8.9),Z=-2.352,P=0.023].Kaplan-Meier survival analysis showed significantdifference in the two groups (the Log Rank test 36.71,P ＜0.01).The levels of 3 predictive factors were predominantly higher in non-survivors than survivors [MEDS score:14.1 ± 6.7 vs.8.2 ± 4.5,t=-6.929,P=0.000; APACHE Ⅱ score:28.1 ±7.1 vs.22.2± 11.3,t=-6.472,P=0.000; lactate (mmol/L):5.4 (2.9,11.0) vs.3.8 (1.2,9.1),t=-6.472,P=0.004].The AUCs were 0.813,0.706 and 0.727 for MEDS score,APACHE Ⅱ score and blood lactate respectively.The predictive ability for 28-day mortality of MEDS score was better than blood lactate (P=0.008) and APACHE Ⅱ score (P=0.005).The AUC of MEDS score combined with lactate was 0.865,and 28-day mortality prediction was better than MEDS score (AUC 0.865 vs.0.813,P＜0.001).The sensitivity (83.1％),specificity (93.2％),positive prediction value (PPV,62.4％),and negative prediction value (NPV,92.1％) for MEDS score combined with lactate were highest among all predictors.Conclusion MEDS score combined with lactate is a good risk stratification tool for emergency patients with severe sepsis,and its prognostic capability is better than either MEDS score,APACHE Ⅱ score or blood lactate.

Objective To investigate the clinical characteristics,peripheral insulin sensitivity,and β-cell function in patients with ketosis-prone diabetes(KPD).Methods Thirty-one patients with newly diagnosed ketosisprone diabetes were admitted to West China Hospital from January 2004 to December 2009.They were divided into 2 groups according to their body mass index (BMI):OB-KPD (BMI ≥ 25 kg/m2,n =22) and Lean-KPD (BMI ＜ 23 kg/m2,n =9).10 patients with newly-onset type 2 diabetes free from ketosis (OB-DM:BMI ≥ 25 kg/m2,n =10) were enlisted as control.Detailed assessments of medical history and symptoms of hyperglycemia were performed.The islet cell antibody (ICA),insulin autoantibody (IAA),anti-glutamic acid decarboxylase antibody (GAD-Ab),fasting plasma glucose,serum insulin,C-peptide and free fat acids concentrations were measured.All of the subjects underwent oral and intravenous glucose tolerance tests,euglycemic-hyperinsulinemia and hyperglycemia clamp test,to evaluate the insulin secretion and insulin sensitivity respectively.Insulin sensitivity was determined by glucose disposal rate (GDR) of steady state during euglycemic clamp and acute insulin secretion was calculated by insulin area under curve(AUCins 0-10 min) during IVGTT.Maximal insulin secretion was determined by glucose infusion rate (GIR) and serum insulin concentration of steady state during hyperglycemic clamp test.Results Age,sex,duration of diabetes were matched among groups.A family history of diabetes was strongly associated with those patients with obesity,compared with lean ketosis prone diabetes(16/22 vs 1/9).GDR was (4.91 ± 1.82) mg · kg 1 · min-1 in subjects with OB-KPD,being lower than that in Lean-KPD patients[(6.26 ± 1.89) mg · kg 1 · min-1] and OB-DM group[(6.78-± 1.69) mg · kg 1 · min-1,P＜0.01].Serum insulin and C-peptide in OB-KPD patients were higher than Lean-KPD patients.Area under the insulin curve [AUCins0-10min (183.86 ± 31.1) mIU/L] and GIR[(2.65 ±1.53) mg · kg-1 · min-1] in OB-KPD patients were lower than those in OB-DM group[(697.06-± 231.9) mIU/L,(6.53 ± 2.21)mg · kg 1 · min-1,P＜0.0 1],but slightly higher than the Lean-KPD group [AUCins0 10min (92.1 ±29.8) mUU/L,GIR (2.55 ± 1.49) mg · kg 1 · min-1,P＜0.05].Glucose disposal rate (GDR) was strongly associated with casual plasma glucose (r =-0.502,P＜0.01),HbA1C(r =-0.553,P＜0.0 1) and FFA eoneentrations (r=-0.504,P＜0.01) on admission.Conclusions Insulin resistance and β-cell dysfunction coexist in all KPD patients.OB-KPD patients exhibit more severe insulin resistance,while Lean-KPD patients have lower insulin secretion.KPD patients had severe hyperglycemia,hypertriglyceridemia,and high plasma FFA levels on admission,suggesting that hyperglycemia and elevated FFA levels could result in serious insulin resistance,β-cell dysfunction,and diabetic ketosis in patients with KPD.

BACKGROUND: Previous studies demonstrated that eucommia bark can promote bone marrow stern cells (BMSCs) differentiated into osteoblasts, but relative mechanism is poorly understood. OBJECTIVE: To investigate the effects of eucommia bark water/methanol extracts on expressions of osteopontin (OPN) and osteoprotegedn (OPG) in rat BMSCs. METHODS: Totally 2 g eucommia bark powder were added into water or methanol to 16 mL and oscillated for 1 hour at room temperature. After soaked overnight, both extracts were centrifuged at 15 000 r/min for 10 minutes. Water extract was obtained from supernatant in water soaked powder. In methanol soaked powder, methanol extracts was obtained by concentrated supernatant in vacuo and resolved using 16 mL water. Water and methanol extracts were then filtered by 0.22 μm membrane, and conserved at -20℃. Six SD rats, aged 2 months, were selected, and the 3~(rd)passage of BMSCs were induced by water or methanol extracts with dilution of 1 × 10~(-2), 1 × 10~(-3), 1 × 10~(-4) and 1 × 10~(-5), respectively. PBS was added in the negative control group. All cells were cultured for 6 days. Expressions of OPN and OPG was measured by immunocytochemistry at 6 days with induction. The expression of OPN and OPG induced by water and methanol at 1 ×10~(-3) and 1×10~(-4) dilution was detected by RT-PCR. RESULTS AND CONCLUSION: Immunocytochemistrical results indicated that both water and methanol extracts of eucommia bark simulated OPN and OPG expression, in particular with dilution of 1×10~(-4). The methanol extracts had a stronger effect than water extract, but the expression of OPG did not change obviously. RT-PCR demonstrated that at the 3rd day of inducement, the level of OPN expression induced by water extract was higher than that of methanol extract, and no OPG expression was detected. Osteogenic differentiation of rat MSCs induced by eucommia bark water/methanol extracts relates to stimulating expression of OPN, which has no correlation to OPG. OPN expression induced by water extract is early than that of methanol extract.

Bone Screws ; Child ; Device Removal ; methods ; Epiphyses, Slipped ; surgery ; Female ; Humans