Adolescent ; Child ; Child, Preschool ; Female ; Heart Rate ; Humans ; Male ; Sleep Apnea Syndromes ; diagnosis ; physiopathology ; Sleep Arousal Disorders ; diagnosis ; physiopathology

To study the effect of glucagon-likepeptide 1(GLP-1)receptor agonist on insulin resistance and hepatic oxidative stress in rats with diabetes mellitus combined with nonalcoholic fatty liver disease. 36 male SD rats were served as the experimental animal and randomly divided into control group, model group, and GLP-1 group. The rats of control group were given routine diet with intraperitoneal injection of normal saline, those in model group were given high fat diet and intraperitoneal injection of normal saline, while GLP-1 group rats were fed with high fat diet and intraperitoneal injection of liraglutide. After 4 weeks of treatment, insulin resistance, lipid metabolism, liver injury and oxidative stress were all assessed. Serum fasting blood glucose, fasting insulin, total cholesterol, triglyceride, alanine transaminase(ALT), aspartate transaminase(AST)levels and total cholesterol, triglyceride contents in liver tissue, and as well as homeostasis model assessment for insulin resistance(HOMA-IR)levels of model group were significantly higher than those of control group, complex insulin sensitivity index(ISIcomp)level was significantly lower than that of control group; serum fasting blood glucose, fasting insulin, total cholesterol, triglyceride, ALT, AST contents and HOMA-IR levels of GLP-1 group were significantly lower than those of model group, ISIcomp level was significantly higher than that of model group; superoxide dismutase(SOD), glutathione peroxidase(GSH-Px), catalase(CAT)contents in liver tissue of model group were significantly lower, while malondialdehyde content and SOD, GSH-Px, CAT, NF-E2 related factor-2(Nrf-2), antioxidant response element(ARE), heme oxygenase-1(HO-1), quinone oxidoreductase-1(NQO-1), glutathione thiol transferase(GST)mRNA expression were significantly higher than control group; SOD, GSH-Px, CAT contents and SOD, GSH-Px, CAT, Nrf-2, ARE, HO-1, NQO-1, GST mRNA expression in the liver tissue of GLP-1 group were significantly higher, while malondialdehyde content was significantly lower than that of model group. GLP-1 receptor agonist reduces insulin resistance and liver oxidative stress injury in diabetic rats with nonalcoholic liver disease.

Objective: To investigate the genes differently expressed in the livers of Kkay diabetic and normal mice, providing data to prevent human from diabetes and its chronic complications. Methods: cDNA microarray chips containing 8 192 cDNAs were used to investigate the gene expression pattern of the liver in Kkay mouse. Results: One hundred and fifty four genes were screened out, comprising 68 complete cDNAs and expressed sequence tags, among them 40 genes were up regulated and 114 genes were down regulated. Conclusion: The pathogenesis of type Ⅱ diabetes is complicated, including the disorder of the metabolism of carbohydrate, fat and protein, and many functional abnormalities of a number of vital proteins. [

Based on the analysis of current condition of local medical schools and medi-cal talents demand at the grassroots level,this paper indicates that,taking students’personality development as a breakthrough point,with practice platform construction as main part,supple-mented by multi-knowledge hierarchy and scientific and cultural exposure,backed by workable policy.

Objective To improve the comprehensive understanding and treatment level of the disease by analyzing the clinical characteristics of rheumatoid arthritis (RA) caused by pauciarticular arthritis.Methods The method was retrospective analysis and summary of clinical and laboratory data of 198 cases of patients with RA,in which 98 cases of pauciarticular arthritis belonged to the observation group and 100 cases of polyarticular arthritis belonged to the control group.Results Male patients in observation group were obviously more than those in the control group (t =2.456,P =0.015).Courses of disease was obviously shorter than those in the control group (t =-2.450,P =0.018).The number of involved joints was obviously less than those in the control group (t =-6.316,P ＜0.001).The incidence of morning.stiffness was significantly less than those in the control group (t =-3.884,P ＜ 0.001).Rating scores of disease activity score 28 were significantly lower than those in the control group (t =-8.694,P ＜ 0.001).And positive rate of anti-cyslic citrullinated peptide antibody is significantly higher than those in the control group (t =-2.299,P =0.022).Thyrotrophin levels were significantly higher than those in the control group (t =3.809,P ＜ 0.001).There was no significant differences in age,erythrocyte sedimentation rate and C reactive protein,immunoglobulin and complement level,free triiodothyronine,free thyroxine,blood lipids,blood system and kidney involvement between the two groups (all P ＞ 0.05).Conclusions The conclusion turns out to be that there are no typical clinical manifestations showing that rheumatoid arthrifts is caused by pauciarticular arthritis.Maybe it is the early performance of disease.It is worth attention that concurrent subclinical hypothyroidism turns out to be more.

Objective: To explore the impact of nuclear factor-kappa B (NF-κB) in patients with left-to-right shunt congenital heart disease (CHD) combining pulmonary arterial hypertension (PAH) and its clinical signiifcance. Methods: A total of 78 relevant patients were enrolled in this study. According to mean pulmonary artery pressure (mPAP) measured during operation, the patients were divided into 4 groups: Non-PAH group, the patients with mPAP≤25 mmHg,n=20, Mild PAH group, 25 mmHg mPAP≤35 mmHg,n=21, Moderate PAH group, 35 mmHg45 mmHg,n=23. 2 mL pulmonary artery blood was taken from each patient and plasma level of NF-κB was measured by ELISA to study the relationship between NF-κB and mPAP. Results: Pulmonary arterial plasma levels of NF-κB were increased accordingly as in Non-PAH group was (180.59 ± 10.16) ng/L, in Mild PAH group was (572.83 ± 34.80) ng/L, in Moderate PAH group was (980.85 ± 24.95) ng/L and in Severe PAH group was (1 253.4 ±130.8) ng/L, allP<0.01; NF-κB level was positively related to mPAP (r=0.856,P<0.01). Conclusion: Plasma level of NF-κB was involved in the pathological physiology process of left-to-right shunt CHD combining PAH, it couldbe used as one of the references for distinguishing the severity of PAH and for monitoring the dynamic changes of PAH in relevant patients.

Most chemical medicines have polymorphs. The difference of medicine polymorphs in physicochemical properties directly affects the stability, efficacy, and safety of solid medicine products. Polymorphs is incomparably important to pharmaceutical chemistry, manufacturing, and control. Meantime polymorphs is a key factor for the quality of high-end drug and formulations. Polymorph prediction technology can effectively guide screening of trial experiments, and reduce the risk of missing stable crystal form in the traditional experiment. Polymorph prediction technology was firstly based on theoretical calculations such as quantum mechanics and computational chemistry, and then was developed by the key technology of machine learning using the artificial intelligence. Nowadays, the popular trend is to combine the advantages of theoretical calculation and machine learning to jointly predict crystal structure. Recently, predicting medicine polymorphs has still been a challenging problem. It is expected to learn from and integrate existing technologies to predict medicine polymorphs more accurately and efficiently.

Objective To investigate the clinical outcome and treatment of portal vein thrombosis (PVT) following partial splenic embolization (PSE).Methods From April 2006 to April 2010,105patients with hypersplenism caused by cirrhotic portal hypertension were treated with PSE.Contrastenhanced abdominal computed tomography or magnetic resonance imaging was performed routinely in 60patients before PSE and 1 -3 months after PSE.PVT was detected in 10 patients on images after the procedures.After PVT was diagnosed,4 patients received anticoagulant therapy immediately,and the other 6 patients did not receive therapy.Clinical data of these 10 PVT patients were analyzed retrospectively.Results 3 of 4 patients who received anticoagulant therapy had complete or partial resolution of the thrombus,and one developed mild ascites without thrombosis progression.Of the 6 patients who did not receive anticoagulant therapy,follow-up studies (6- 48 months,mean 16.9 months) demonstrated partial clot calcification in one,thrombosis progression in 5.Among those 5 patients with thrombosis progression,two experienced hematemesis due to variceal rupture and underwent transjugular intrahepatic portosystemic shunt,2 developed cavernous transformation,extensive collateral circulation,ascites and variceal progression,and one had variceal progression with melena during the follow-up period.Conclusions PVT is a severe complication of PSE.Early diagnosis and prompt anticoagulant therapy is effective in preventing PVT.

Objective Background and objective The Cox maze Ⅲ procedure has been considered the gold standard for the surgical treatment of atrial fibrillation (AF) and the modified Cox maze use bipolar radiofrequency ablation instead of the cut-and-sew technique,while also reducing the connecting lines in left atrium.This study was to understand whether completely isolation the posterior left atrium by increasing left atrium ablation lines can enhance the survival after modified Cox maze procedure.Methods From Jan 2009 to Dec 2009,all the patients underwent the Cox maze procedure,following the same examination,were divided into two groups (case-control): box lesion group (n =60),which is means the right and lefi pulmonary vein lesions were connected inferiorly by adding ablation lines,thereby completely isolating the posterior left atrium and the non-box lesion group (n =60).Similar interventions were given during the perioperative periods.Comparing the risk factors before surgeries,then follow-up was 100％ complete,and the mean follow-up was 9 ± 8.4 months.Results Except the box lesion had long time of extracorporeal circulation,the characteristics of the 2 groups were similar because there were no differences in age,AF duration,left atrial diameter,left ventricular ejection fraction or homochronous operation between the groups and there was no operative death.No patient was lost to follow-up.In the mean follow-up duration,a patient was died of intracerebral hemorrhage at 2 months postoperationly in the box lesion group and a patient suffered from stroke at 12 months postoperationly in the non-box lesion.The overall freedom from AF recurrence was higher in the box lesion group at 1 (70％ vs 51.2％,P =0.039) and 3 (78.3％ vs 60％,P =0.030) months.While it was 80％ vs 71.7％ (P =0.286) at 6 months.Eight patients wrere readmitted because of the recurrence of AF,4 and 2 patients underwent catheter ablation in box and non-box group respectively,one patient in each group underwent electrical conversion.After treatment,all of the patients were recovered to sinus rhythm and continued to take cordarone.Conclusion Compared to the single connecting between right and left pulmonary vein,isolating the entire posterior left atrium by creating a box lesion showed higher freedom from AF in the earlier months (1-3months).However,half a year after the surgery,there were no significant differences between the two groups.

Chronic kidney disease(CKD)is a major public health problem worldwide. Understanding by doctors and laboratorians of the importance of reliable serum creatinine measurement in GFR estimation and of factors that may affect creatinine measurement is critical to ongoing public health efforts to improve the diagnosis and treatment of patients with CKD.We present an overview of the commonly used methods,their performances and limitations and the required performance criteria for the measurement of serum creatinine.Available resources for standardization of serum creatinine measurements and recommendations for creatinine measurement and GFR estimations are introduced.