Objective To investigate the probable risk factors for type 2 diabetic patients complicated nonalcoholic fatty liver disease (NFLD)in elderly, through comparing the body composition, serum lipid profile, incidences of abdominal obesity and metabolic syndrome (MS) between elderly type 2 diabetic patients with and without NFLD. Methods The enrolled elderly type 2 diabetic patients were divided into NFLD group (n=83) and non-NFLD group (n=85). Their clinical data including body composition, serum lipid profile, incidences of abdominal obesity and MS were analyzed retrospectively and compared. Results Compared with non-NFLD group, the BMI [(26.9±2.5) kg/m~2 vs. (24.1±2.5) kg/m~2, P=0.000], waist-hip ratios (WHR) ((0.92±0.07) vs. (0.87±0.06), P=0.000], total body fat percentage [(29.6%±6.6%) vs. (25.3%±5.5%),P=0.000], abdominal fat [(11.0±2.5) kg vs. (8.7±2.3) kg, P=0.000], visceral fat [(3.0±0.7) kg vs. (2.3±0.6)kg, P=0.000], visceral fat area [(97.6±22.2) cm~2 vs. (75.5±21.1) cm~2,P=0. 000], serum triglyceride [(1.98±0.94) mmol/L vs. (1.22±0.61) mmol/L, P=0.000]were all increased, while serum HDL [(1.23±0.32) mmol/L vs. (1.40±0.37) mmol/L, P=0.002]was decreased in NFLD group. The incidences of over-body fat (68.7% vs. 36.5%, P=0. 000),dyslipidemia (47.0% vs. 21.2%, P=0. 000), abdominal obesity (69.9% vs. 43.5%, P=0.001) and MS (49.4% vs. 9.6%, P=0.000) were obviously increased. But there were no statistical differences in serum TC [(4.93±0.94) mmol/L vs. (4. 73±1.07) mmol/L, P=0.219]and LDL [(3.23±0.80) mmol/L vs. (3. 07±0.89) mmol/L, P=0. 229]between the two groups. Logistic regression showed that high BMI (β=1.268, P=0.000, OR=3.56), over-total body fat percentage (β=0.902, P=0.023, OR=2.47)and the existence of MS (β=1. 664, P=0. 000, OR=5.28) were related to elderly type 2 diabetic patients complicated NFLD. Conclusions The high BMI, over-total body fat percentage are related to elderly type 2 diabetic patients complicated NFLD, and NFLD is probably one of components of metabolic syndrome.

Objective To observe the postconditioning cardioprotective effects of atorvastatin (ATV) on ischemia-re?perfusion injury in isolated rat heart, and the role of phosphatidylinositol-3-kinase , protein kinase B(PI3K-Akt), mitochon?drial ATP-sensitive potassium (mito-KATP channel) and mitochondrial permeability transition pore (mPTP) thereof. Meth?ods Healthy male Wistar rats were randomly divided into 9 groups:ischemia reperfusion (I/R) control group, atorvastatin postconditioning (ATV) group, ATV plus PI3K inhibitor LY294002 (ATV+LY294002) group, LY294002 group, ATV plus mi?to-KATP channel inhibitor 5-hydroxydecanoate (ATV+5-HD) group, 5-HD group, ATV plus mPTP inhibitor ATR (ATV+ATR) group, ATR group and ethanol group. Model rats were given 30-min ischemia followed by 120-min reperfusion. The myocardial infarction size, hemodynamic parameters, creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), nic?otinamide adenine dinucleotide (NAD+) and the expression of myocardial protein kinase B (Akt) and myocardial phospho-pro?tein kinase B (p-Akt) were evaluated. Results Compared with the control group, atorvastatin reduced the myocardial in?farction size, CK-MB and LDH(P<0.05), increased NAD+(P<0.05). There were no significant differences in the myocardi?al infarction size, CK-MB, LDH and NAD+between ATV+LY294002 group, ATV+5-HD group and ATV+ATR group. The hemodynamic parameters were improved in ATV group compared with those in control group. Western blot analysis con? firmed the significant phosphorylation of Akt in ATV group, ATV+5-HD group and ATV+ATR group compared with those of control group. There were no significant differences in the phosphorylation of Akt between ATV +LY294002 group, LY294002 group, ATR group and 5-HD group. Conclusion Atorvastatin postconditioning could attenuate the ischemia-re?perfusion injury through activating the PI3K-Akt, promoting mito-KATP channel opening and inhibiting mPTP opening.

Objective To introduce Checklist Individual Strength(CIS)into China,and evaluate its reliability and validity.Methods CIS was translated into Chinese language and the reverse translation was done by several experts.Validity and reliability were implemented in 214 cases with cerebral infarction.Results 4 components were extracted in factor analysis,and the total cumulative contribution was 78.984%.By correlation analysis,the twenty items were divided into 4 domains:subjective feeling of fatigue,concentration,motivation and physical activity,it was same as in the English version.Cronbach α of four domains were 0.9256,0.9072,0.7598,and 0.9157,respectively.Conclusion Psychometric properties(reliabilities and validities)of CIS Chinese version is met with satisfaction and seems to be adaptable to Chinese cerebral infarction patients.

Objective To analyze the instruments for post stroke fatigue, Fatigue Severity Scale (FSS)，Checklist Individual Strength (CIS) and Fatigue Impact Scale (FIS). Methods The FSS，CIS and FIS were applied in 214 cases with cerebral infarction. They were combined together at the (sub)scale level, and evaluated with Mokken Scale Analysis for Polytomous Items, for validity and reliability. Results and Conclusion Three scales were and The combined scale proved to be acceptable (H>0.5). 3 components were extracted in factor analysis, and the their total cumulative contribution was 77.504%, with reliability (α) of 0.8097，0.7094 and 0.8019 respectively. FSS put emphasis on the fatigue experiences of stroke patients, CIS on the influence of fatigue on, and FIS on the social function.

Body Mass Index ; Humans ; Male ; Middle Aged ; Obesity, Abdominal

Objective KG1This study is to evaluate defectography in postoperative defecation function of Hirschsprung′s disease (HD). KG2MethodsKG1 Between 1979 and 1993, 30 HD cases were treated operatively and followed-up by defectography. KG2ResultsKG1 Thirty cases were classified into 3 groups, according to the standard quantitative clinical scoring systems with the stooling score from 0 to 14. There were 4 cases (13%) graded as excellent (maximum score of 14) with normal bowel habit, 21 cases (70%) as good (score between 10～13) with minor continence problems, 5 cases (16 7%) as fair (score between 5～9) with marked limitations in social life. Anorectal manometry study showed that the anal resting pressure and voluntary sphincter force (maximal queeze pressure minus resting pressure) in fair group were significantly lower than that in control group( P

Objective To investigate the expression of nuclear factor-κB (NF-κB) and p53 up-regulated modulator of apoptosis (PUMA) in acute lung injury (ALI) induced by severe acute pancreatitis (SAP), and the therapeutic role of proline dithiocarbamate (PDTC). Method SD rats weighed 200～ 250 g were randomly(random number) divided into sham operation group (A group, n = 18), ALI group (B group, n = 18) and PDTC treatment group (C group, n = 18). The model of SAP was eastablished by injecting 1 mL/kg of sodium tauarocholate into the pancreatic capsule of the rats in B group and C group. The model rats in C group were treated with PDTC one hour after modeling. Six rats of each group were sacrificed 6 h,12 h, and 24 hours after modeling. The histopathological changes in lung and pancreas were observed. The levels of NF-κB p65 and PUMA in lung were detected by using Western blotting, and the expressions of bcl-2, bax and caspase-3 mRNA in the lung were detected by using RT-PCR. The lung tissue was taken for examination under transmission electron microscope. TUNEL was used for detection of apoptotic alveolar epithelial cells. Results Six to 24 hours after modeling, the pathological scores in lung of ALI group were significantly higher than those of control group and PDTC group after sodium taurocholate injection ( P ＜ 0.05). The levels of NF-κB p65 and PUMA, and the expressions of bax and caspase3 mRNA in ALI group at different intervals were higher than those in control group and PDTC group ( P ＜ 0.05),whereas the expression of bcl-2 mRNA in ALI group was lower than that in control group and PDTC group ( P ＜0.05). The NF-κB p65 was correlated closely and positively with PUMA ( r= 0.987, P ＜ 0.01). Higher activity of caspase-3 acrtive units was seen in ALI group than that in control group and PDTC group ( P ＜ 0.05). The microvilli disappeared in ALI group 24 hours later. The apoptosis index in ALI group was higher than that in control group and PDTC group ( P ＜ 0.05). Conclusions The apoptosis of alveolar epithelial cells of rats in ALI group is caused by PUMA activated by NF-κB. PDTC treatment can inhibit apoptosis of alveolar epithelial cells of rats in ALI group by inhibiting the activation of NF-κB.

Objective To investigate the clinical efficacy and safety of temperature-controlled radiofrequency ablation(TCRF)for treatment of elderly patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods From March 2009 to June 2010,52 elderly patients with OSAHS confirmed by polysomnography(PSG)were treated with TCRF under local anesthesia.PSG monitoring was used preoperatively and 6 months postoperatively to determine the therapeutic effect.Apnea hyponea index (AHI),the lowest blood oxygen saturation(LSaO2),sleep apnea quality of life index(SAQLI)and the Epworth sleepiness scale(ESS)were assessed before and 6 months after operation.Results All these cases were reevaluated with PSG by the end of postoperative period lasted for 6 months.Thirteen cases were cured,18 cases were significantly improved,15 cases were improved,6 cases were not improved,with a total effective rate of 88.5％(46/52).No serious complications occurred.After operation,AHI decreased from (47.8 ± 13.7)times/h to(13.5 ± 7.3)times/h,LSaO2 increased from 0.677 ± 0.095 to 0.808 ± 0.056,SAQLI increased from(3.53 ± 0.43)scores to(5.01 ± 0.22)scores and ESS scores decreased from(14.93 ± 3.13)scores to(5.33 ± 2.52)scores,all above index had significant differences(P＜ 0.01).Conclusions TCRF for elderly patients with OSAHS is effective,and can improve their health-related quality of life.This treatment is convenient,simple,minimally invasive,repeatable,without serious complications,and can be especially suitable for surgical treatment of elderly patients with mild and moderate OSAHS.

Objective To study the effect of the ultrasound scalpel and electric knife in axillary lymph node dissection in modified radical mastectomy for breast cancer.Methods The clinical data of 429 patients with modified radical mastectomy for breast cancer were analyzed retrospectively.The axillary lymph node dissection in 178 cases were performed with the ultrasound scalpel (ultrasound scalpel group) and 251 cases were done with the electric knife(electric knife group).The blood loss,operative time,extubation time,the total amount of drainage,the incidence of seroma were compared.Results Two groups were successfully operated,no axillary vessels and long thoracic nerve,chest nerve injury.The blood loss,operative time,extubation time,the total amount of drainage in ultrasound scalpel group were significantly better than those in electric knife group [(98.0 ± 10.2) ml vs.(152.0 ± 11.5) ml,(125.0 ±9.6) min vs.(155.0 ± 12.3) min,(6.0 ± 2.1) d vs.(9.0 ± 4.3) d,(227.0 ± 10.6) ml vs.(319.0 ± 15.8) ml,P＜ 0.05 or ＜ 0.01].The incidence of seroma was no significant difference between two groups (P ＞ 0.05).Conclusions Using ultrasound scalpel in axillary lymph node dissection for breast cancer can significantly reduce operative time,and is consistent with less blood loss,less extubation time and the total amount of drainage.

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