Objective To study the association of sex, body mass index and insulin resistance with serum leptin in patients with type 2 diabetes. Methods one hundred and eight patients were divided into two groups according to BMI: diabetic obese group and diabetic normal BMI group.Their weight and height were measured. Fasting plasma glucose(FPG),fasting true insulin(FTI),postprandial true insulin(PTI),and fasting serum leptin(LEP) were also measured. ISI=1/(FPG?FTI) as insulin sensitivity index were used to analyse the relation between leptin and insulin resistance. Results ⑴The serum leptin,body mass index,FTI and PTI were significantly higher in diabetic obese group than diabetic normal BMI group. ISI was significantly lower in diabetic obese group than diabetic normal BMI group. ⑵Female serum leptin levels were significantly higher than male serum leptin levels in diabetic obese group and diabetic normal BMI group. ⑶Fasting leptin was correlated with sex. Leptin was positively corrected with body mass index,FTI and was negatively corrected with ISI. Serum leptin wasn't correlated with FPG. Conclusin Serum leptin level is associated with sex,BMI and insulin resistance in patients with type 2 diabetes.

Objective To explore the influence of allergic rhinitis (AR) on patients with systemic onset juvenile idiopathic arthritis (SoJIA).Methods The study involved 44 cases with SoJIA from Department of Pediatrics,Renji Hospital affiliated to School of Medicine of Shanghai Jiaotong University from July 2008 to November 2013.The Clinical and laboratory data of all patients were recorded respectively.This was a retrospective cohort study.According to the diagnosis of allergic rhinitis (AR),children were subdivided into AR group (16 cases) and Non-AR group (28 cases).ACR Pediatric criteria (ACR Pedi) 30/ 50/70 and related indicators of SoJIA between the two groups were compared.In the AR group,the correlation between AR scores and DAS28 was analyzed.When SoJIA of the two groups relapsed,the AR group (the treatment group) received anti-rheumatism for arthritis as well as nasal spray and oral antihistamines for AR.The non-AR group (control group) only received the anti-rheumatism for arthritis.The improvement of SoJIA between the two groups was analyzed.The continuous variables were analyzed by Student's t-test or the MannWhitney U-test as appropriate.Categorical data were compared between different groups by the Chi-square test.Correlations were determined by Pearson or Spearman's ranking.Results ① In the retrospective analysis:the physician's and patients'/parents' general assessment on a 10 cm visual-analogue scale (VAS),number of joints with res-triction of movement,number of swollen joints,ESR,serum ferritin(SF) and childhood health assessment questionnaire (CHAQ) score were significantly elevated in the AR group compared with Non-AR group at the disease onset [(6.7±1.0) cm vs (4.8±1.9) cm; (6.5±1.4) cm vs (3.2±1.5) cm; 4.1±2.7 vs 2.7± 1.7; 3.4±2.4 vs 1.4±1.5; (87±35) mm/1 h vs (61±40) mm/1 h; (888±1 043) μg/L vs (311±324) μg/L; 1.6±0.5 vs 0.7±0.3,respectively; all P＜0.05].At the 3 and 6 months follow-up after disease onset,the proportion of patients who reached ACR pedi 50,70 in AR group were lower than the Non-AR group,while the cumulative glucocorticoid dose was higher in the AR group than that of those without AR [at 3 months 38％ vs 71％; 13％ vs 46％; (76±35) mg/kg vs (43±36) mg/kg,respectively; at 6 months 25％ vs 71％; 19％ vs 64％; 127±57 vs 67±58,respectively,all P＜0.05]; In the AR group,at the disease onset,3 and 6 months follow-up after disease onset,the scores of AR was positively correlated with DAS28(r=0.741,0.703,0.680,respectively; all P＜0.05).② In the prospective study:when SoJIA was relapsed,systemic feature score,the physician's and patients' /parents' general assessment on a l0 cm VAS,number of joints with restriction of movement,number of swollen joints,ESR,SF and CHAQ score were significantly elevated in the treatment group compared with the control group [3.8±1.5 vs 2.1±1.1; (5.6±1.5) cm vs (4.5±1.6) cm; (4.6±1.9) cm vs (3.1±1.5)cm; 3.9±1.9 vs 2.5±1.4; 2.4±0.9 vs 1.5±1.2; 92±27 vs 53±37; 565(339,1 192) μg/L vs 171(85,284) μg/L; 13(0.8,1.6) vs 0.7(0.5,1); respectively; P＜0.05].The improvement rate of the physician's and patients'/parents' general assessment on a 10 cm VAS,number of swollen joints,number of joints with restriction of movement,ESR and CHAQ score at the follow-up 3 months were higher in treatment group than the control group [71(55,86)％ vs 46(0,75)％; 67(45,81)％ vs 28(-4,62)％; 92(77,96)％ vs 70(27,88)％; 65(48,81)％ vs 0(-17,67)％; 100(46,100)％ vs 42(0,100)％; 67(49,85)％ vs 37(0,75)％; P＜0.05].At the follow-up 6 months,the improvement rate of ESR,patients'/ parents' general assessment on a 10 cm VAS,number of joints with restriction of movement and CHAQ score were higher than control group [94(85,96)％ vs 73(33,85)％; 89(65,99)％ vs 63(5,85)％; 100(100,100)％ vs 100(0,100)％; 91(69,100)％ vs 72(11,91)％; respectively,P＜0.05].Conclusion AR may exert an adverse influence on SoJIA.SoJIA patients who are treated with combined with AR may have better outcome than those who are only treated for arthritis.

Objective:To investigate the articulation characteristics of /n/ and /l/ consonant disorder and seek for a therapy method.Methods:Listening judge and sound examine were used to investigate the category and /n/ and /l/ consonant's word groups and sentences for 16 patients.Chinese articulation and articulation pathology study were conducted.The new method of articulation therapy including tongue movement training, articulation training of consonant /n/ and /l/.The therapy was performed 3 times a week, 40 min for each time. Results:After treatment the speech intelligibility of the 16 patients increased from 75.8% to 98.8%, /n/ and /l/ consonant's intelligibility increased from 45.0% to 98.1%.Conclusions:The therapy is effective in the improvement of speech intelligibility,especially in articulation of consonant /n/ and /l/.

Aim To explore the effects of hypertension on the contractibility of rat basilar artery and its inter-actions with the sodium pump activity.Methods The basilar artery was respectively isolated from Wistar and SHR rats,and the isometric tension of arterial rings was measured by Multi Myograph System-610M.The cont-ractibilities of arterial rings induced by KCl or 5-HT were compared between the basilar arteries of the two groups of rats to analyze the effect of hypertension on the cerebral vascular tension and the activity of sodium pump.Results In SHR rats,the concentration-re-sponse curves of the contraction of isolated basilar ar-tery rings induced by KCl and 5-HT were significantly shifted to right,and the relaxation of vascular tone in-duced by K+which was reintroduced from the external was attenuated compared with those in the WR.These results suggested that hypertension could significantly decrease the activity of the sodium pump and the con-tractile responses of KCl and 5-HT.OUA could con-tract the basilar artery in a concentration-dependent manner,and its concentration-response curve was opti-mally fitted by a two-site binding model:Kd was 1.7 ×10 -8 and 1.6 ×10 -5 mol·L-1,respectively.The results indicated that the two different function sodium pumps existed in the rat basilar artery:one with the high OUA affinity and the other with the low OUA af-finity.If the high and low affinity sodium pumps were inhibited by 5 ×10 -7 and 10 -4 mol · L-1 OUA,re-spectively,the concentration-response curves of KCl and 5-HT would shift to left in SHR rats but not in WR rats.It suggested that OUA could enhance the contrac-tion induced by KCl and 5-HT significantly,and a concentration-dependent effect was observed in the SHR vascular contraction induced by 5-HT (r =0.9393 ,P<0.05 ).When the two concentrations of OUA were applied,there was no significant difference in the shift left of the concentration-response curves in-duced by KCl in the SHR cerebral vessels.However, the marked difference was shown in the shift left in-duced by 5-HT.The results implied that only the high affinity sodium pump was involved in the contractile re-sponse of SHR cerebral vascular to KCl,whereas,the contractile response of SHR cerebral vascular to 5-HT was induced by both high and low affinity sodium pumps.Conclusion Hypertension could lower the contractile response of the basilar artery to vasocon-strictors,and the mechanism might relate to the de-creased sensitivity of the sodium pump induced by hy-pertension or the increased sensibility of the sodium pump to OUA.

Objective To find out a treatment with high remission rate,long living period,and a good quality of life for elderly patients with multiple myeloma.Methods All patients were recruited into a treatment group(treated with traditional Chinese medicine,routine chemotherapy,and thalidomide)and a comparison group(treated with traditional Chinese medicine and routine chemotherapy).Results The total effective rate of the treatment group was 71.4%,higher than the comparison group(38.5%),but showing 110 statistical difference(P=0.128＞0.05).Median survive time of two groups were 21.8 months and 12 months respectively,(P=0.001＜0.01).The survival rate of 3 years and 5 years were 28.6%,15.4%and 7.1%,0 in the two groups respectively,without significant difference(0.317,1.000,both P＞0.05).Conclusion The treatment group showed higher results in both complete remission rate(CR)and very good partial remission rate(VGPR)than the comparison group,demonstrating a better results in improving the patient's quality of life.The treatment group also had a higher value of the median survive time and the median progression-free surial time than the comparison group.The combined therapy of traditional Chinese medicine,routine chemotherapy and thalidomide is an ideal choice for both aged Patients or young MM patients who had no transplant conditions.

Objective To investigate how to improve the survival rate,and to avoid the serious complications in fat grafting.Methods Under comprehensive design of facial filling area,the fat was harvested by concentration in mesh;under the micro autologous fat transplantation gun with blunt needle injection technique,the fat was filled into the face to achieve the effect of improving the facial contour and the rejuvenation.From June 2014 to July 2015,78 patients with facial contour and facial soft tissue relaxation depression were treatment by the technique.Results The follow-up of 2 months to 1 year showed that 64 patients had the soft,young,significantly enhanced facial contour;7 patients had second times grafts and the remaining were satisfied.7 patients gave up the second times grafts because the other reasons.The surgical complications such as facial nerve injury and infection and embolism were not seen.Conclusions This technique by comprehensive design and purification of autogenous fat granules achieves a better effect on facial rejuvenation with fewer complications.

Objective To design an auxiliary measurement device for anterior cruciate ligament injury in order to improve the accuracy of specialist examination and postoperative functional assessment.Methods The device consisted of a main frame and support pads,which was designed based on the principles of anatomopathology and mechanical mechanics.The frame was set above and paralleled to the tibia,and the measurement scale was put at the vertical direction of the frame.The support pads were fixed to the tibia and patella respectively to execute auxiliary measurement by providing opposite acting force.Results The success rate of preliminary diagnosis by the device was higher than that by traditional method.Conclusion The device gains advantages in convenience,practicality,low cost and etc,and is worthy promoting in the orthopedics department.

Aim To investigate whether Rhizoma curcumaecould induce pregnane X receptor(PXR)-mediated transcriptional expression of CYP3A4 and study the modulatory effects on the enzyme activity and mRNA expression of CYP3A in the rat liver.Methods Transient cotransfection reporter gene assays were performed in HepG2 cells;the rat liver microsomal cytochrome P450 and CYP3A isoenzyme-erythromycin N-demethylase(ERD)activities were determined by UV chromatography;the mRNA expression level of CYP3A was detected by reverse transcriptase-polymerase chain reaction(RT-PCR).Results In vitroinvestigation showed Rhizoma curcumaeand its four selected constituents could induce the CYP3A4 transcriptional expression by activating PXR.In vivoinvestigation showed the CYP450 content of liver microsomes and enzyme activity of CYP3A were markedly increased and induced by Rhizoma curcumaeextract;at the mRNA level, the expression of CYP3A1 and CYP3A2 gene were markedly induced by Rhizoma curcumaeextract.Conclusions Rhizoma curcumaeand its four selected constituents could induce the expression of the CYP3A4 gene transcriptional expression through activating PXR;Rhizoma curcumaeextract could increase and induce the enzyme activity and mRNA expression of CYP3A.

Objective To summarize key points of nursing patients with cosmetic dermatitis during patch test.Method One hundred and forty one patients with contact dermatitis induced by cosmetics underwent patch test and the nursing care was performed. Results The top five allergens based on the positive rate ranked in descending order were potassium dichromate(43?97%),nickel sulfate (43?26%),cobalt chloride(36?17%),mixture of hydroxy benzoic acid(23?40%)and fragrance mix(20?57%).The positive suspicious cosmetics ranked in ascending order included body spray(80?00%),freckle cream(56?00%),liquid products(38?89%),cleaning supplies (31?58%)and skin care cream(25?62%).Conclusion During the cosmetic patch test for the patients with contact dermatitis,the nurses should conduct mental care,carefully observe the patients and make instructions to them on cosmetic health knowledge.

Objective To investigate the risk factors of mild cognitive impairment (MCI) in patients with type 2 dia-betes (T2DM), and the clinical evidence for the early diagnosis and treatment thereof. Methods A total of 217 T2DM pa-tients were divided into T2DM with MCI group (n=92) and T2DM with normal cognitive function(NMCI) group (n=125). Mon-treal cognitive assessment scale (MoCA) and activities of daily living scale (ADL) were used to assess the functional status in two groups of patients. The general clinical data and biochemical indicators were obtained and compared in two groups. Re-sults There were statistical differences in age, smoking history, education status, high sensitive C reactive protein (hs-CRP), coronary heart disease, hypertension, glycated hemoglobin A1c (HbA1c) and T2DM history between two groups. Re-sults of univariate logistic regression analysis showed that old age, longer course of T2DM, smoking history, higher hs-CRP and HbA1c, complicated with coronary heart disease and hypertension were risk factors for T2DM with MCI, while the higher education status was a protective factor. Multiple logistic regression analysis showed that old age and longer T 2DM history were risk factors, and the higher education was a beneficial factor for T2DM with MCI. Conclusion Many risk factors may play a part in T2DM with MCI. Early detection and prompting medical attention may help prevent and decrease the preva-lence of MCI in patients with T2DM.