ObjectiveTo study the relationship between GDNF and ChAT Mrna and their potential role in the diabetic cognitive dysfunction by observing the change of the expression of GDNF and ChAT mRNA in brain under different blood glucose levels in STZ induced diabetic rats.MethodsForty male Wistar rats were randomly divided into diabetic group without blood glucose control( DM1 group),diabetic rats treated with insulin group( DM2 group),and normal control group( NC group).Blood glucose and body weight were detected every 4 weeks.Twelve weeks later,the hippocampus were submitted for cryostat sections which were subjected to the reverse transcription-polymerase chain reaction(RT-PCR) for GDNF and ChAT mRNA.ResultsThe expression of GDNF mRNA and ChAT mRNA in the hippocampus have negative correlation with HbAlc level( r =-0.962,-0.974,all P ＜ 0.001 );The GDNF expression had positive correlation with the ChAT mRNA expression( r =0.974,P ＜ 0.001 ).ConclusionLongterm chronic hyperglycation caused the “downregulation” of the GDNF expression in the hippocampal,which could cause the central cholinergic dysfunction symbled with the decrease of ChAT mRNA expression and the decline of learning and cognition ability.

Objective To observe the effects of dexmedetomidine on the perioperative stress response and immunologic function in hepatectomy patients with hepatitis cirrhosis.Methods Forty patients(Child-Pugh A or B),ASA Ⅱ or Ⅲ with hepatitis cirrhosis undergoing hepatectomy were randomly divided into dexmedetomidine group(group D)and control group(group C)with 20 cases in each.Patients in group D were administered 0.5 μg/kg bolus dose of dexmedetomidine over 10 min, followed by 0.4 μg·kg-1 ·h-1 infusion until closing abdomen.And patients in group C were given normal saline by the same way as in group D.Flow cytometry was used to detect peripheral blood T lymphocytes (CD3 + ,CD4 + ,CD8 + ,CD4 +/CD8 + ),NK cells at 30 min before anesthesia(T0 ),imme-diately(T1 ),24 h(T2 )and 48 h(T3 )after surgery.Enzyme-linked immunosorbent assay was used to detect the levels of inflammatory cytokines concentration(IL-2,IL-10)at T0-T3 and stress hormones (Cor,ACTH,ALD)at T0 ,T2 and T3 .The levels of SBP,DBP and CVP at T0 ,immediately with intu-bation(Ta ),T1 and extubation(Tb ).Results Compared to those at T0 ,the levels of CD3 + ,CD4 + , CD8 + ,CD4 +/CD8 + at T1 and T2 were significantly lower in both groups(P <0.05),and the levels in group D were obviously higher than those in group C(P <0.05).The levels in group D were back to preoperative levels at T3 ,but the levels in group C were still lower than those at T0 (P <0.05).The levels of NK cells were higher at T1 in both groups,and the levels in group D was significantly higher than those in group C(P <0.05).Compared to those at group D,the concentration of IL-2 was lower at T1 and T2 ,the concentration of IL-10 was higher at T2 and T3 in group C (P <0.05).The levels of Cor,ALD,ACTH at T2 and T3 were significantly higher than those at T0 in both groups,but those in group D were markedly lower than those in group C (P < 0.05 ).The SBP,DBP and CVP of two groups was no statistically significant difference at T0 ,and SBP,DBP and CVP of the group D at Ta , T1 ,Tb was lower than that of T0 and group C (P <0.05).Conclusion Patients with hepatitis cirrho-sis underwent general anesthesia has certain immune suppression after liver cancer surgery,and con-tinuous intravenous infusion of dexmedetomidine during anesthesia may suppress the perioperative stress reaction effectively and alleviate the inhibition of immunologic function.

Objective To observe the effect of hyperbaric oxygen therapy (HBOT) on mineral density and biomechanics of new-formed bone in distraction gap.Methods The mandibles were subjected to osteotomy and distractors were placed bilaterly in 30 rabbits,which were divided randomly into 2 groups.After 5 days for latency,the mandibles were distracted at a rate of 0.8 mm/day for 10 days,and then for consolidation.After surgery,group A received HBOT with daily distraction,whereas group B only distracted without HBOT served as control group.The animals in groups A and B were sacrificed 1 wk,2 wk,4 wk of consolidation,respectively.The mandibles were harvested and subjected to examination for new bone formation,and bone mineral density (BMD) and biomechanics of newly formed bone in the distraction gap.Results At one week of consolidation,no significant differences were observed between the BMD of newly formed bone in the two groups (P＞0.05);however,at the other time points,BMD of newly formed bone in group A was significantly higher than that in group B (P＜0.05).Moreover,at 4 weeks of consolidation,the strength,maximum fragile energy and modulus of elasticity of newly formed bone in group A were significantly higher than those in group B (P＜0.05).Conclusions The results suggest that HBOT improves mineral density and strength of new formed bone in distraction gap.

Objective To investigate the effect of postoperative analgesia with oxycodone on T cell function after operative of cesarean section with chronic hepatitis B.Methods Sixty cesarean sec-tion women with chronic hepatitis B undergoing CS,aged 22-35,were randomly divided into two groups:oxycodone group (group O)and morphine group (group M).The changes of immune cells (Th1,Th2)and liver function were recorded after the analgesia (immediate,postoperative 24 h,48 h,72 h).The total number of pressing analgesia pump and the cumulative amount of PCA were re-corded.Results The Th1 of group O was higher than that of group M at 24 h,48 h after operation (P <0.05),while there was no significant difference of Th1 and Th2 in group M.The total patient-controlled pressing times and accumulated amount of PCA of group O were significantly lower than those in group M (P <0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Oxycodone can activate T cell function in postoperative analge-sia,while morphine causes the inhibition of Th1 cells.

Objective To evaluate the effect of fast track surgery nursing on percutaneous lumbar diskectomy. Methods A total of 126 patients were randomly divided into the control group and the experimental group,the control group received traditional nursing plan, the experimental group was given fast track surgery nursing plan. The nursing effect was observed. Results Postoperative anal exhaust time, feeding time, walking time, length of hospital stay ofthe experimental group were (1.61±0.71) days, (2.01±0.71) days, (4.70±2.12) days, (12.72±2.07) days, whichwere significantly shorter than those of the control group, which were (3.37±0.93) days, (2.27±0.63) days, (8.40±3.21) days, (15.81±2.14) days, the difference between two groups were statistically significant (t=4.012-6.068, P<0.05). The incidence of complications was 11.1%(7/63) in the experimental group, which was lowercompared with the control group, 23.8% (15/63), the difference between two groups was statistically significant(χ2=6.639, P < 0.05). Curative effect of the experimental group was 90.4% (57/63), which was significantly higher than that of the control group, 85.7% (54/63), the difference between two groups was not statistically significant (χ2=1.460,P>0.05). The Rdand Morris Questionnaire score of the experimental group was 21.67±3.48, which was higher than that of the control group(14.43 ± 2.01), the difference between two groups was statistically significant(χ2=6.077, P <0.05). Conclusion Fast track surgery nursing can promote the patient's postoperative rehabilitation ,reduce the postoperative complications, shorten the length of hospital stay and improve the quality of life.

Objective To investigate the presence of type 2 diabetes dyslipidemia,and the association with HDL levels and vascular complications in diabetes.Methods Of 524 cases of type 2 diabetes,fasting blood lipids,blood glucose,glycated hemoglobin results,blood basic data,the level of lipid controlling and based data of the patients were observed.The relevance between abnormal blood lipids and vascular atherosclerosis was analyzed.Results Type 2 diabetic patients have lipid metabolism,in 524 type 2 diabetes patients,58.4％ had lipid disorder;The serum level of HDL in atherosclerosis group[(0.8 ±0.26)mmol/L]was significantly lower than that in non-atherosclerotic group[(0.95 ± 0.43)mmol/L](t =1.648,P ＜ 0.05).Conclusion The decreasing of HDL had relationship to vascular atherosclerosis in patients with type 2 diabetes.

OBJECTIVE:To optimize the extraction technology of Paeonia lactiflora. METHODS:The surface figure made by mixed uniform design combined with the quadratic polynomial stepwise regression equation is adopted to optimize the extraction technology of P. lactiflora by using the content of paeoniflorin as index,with extraction solvent,the amount of extraction solvent, extraction time,extraction times as factors. RESULTS:The optimal extraction technology of P. lactiflora was as follows as 90%ethanol,12-folds extraction solvent,extracting for 150 min,extracting for 2 times. The measured value of 3 validation tests were 2.848 4%,2.795 7%,2.841 9%(RSD=0.82%,n=3),which was close to the predicted value 2.848 4%. CONCLUSIONS:The method is convenient and accurate,and can be used for the extraction of P. lactiflora.

Objective To investigate the clinical efficacy of autologous fat transplantation in augmentation mammoplasty with two different methods of purification treatment .Methods Selected 86 patients undergoing autologous fat granule replant mammaplasty .They were randomly and equally divided into the centrifuge group and the static group .After extracting the body fat in the centrifuge group ,obtained the high purity granular fat by using the Centrifugal technique;After the extraction of autologous fat in the static group ,obtain the purified particle fat by using the natural static suspension and physiological saline washed the im‐purities .Respectively ,the processed fat was injected the breast of two groups with multi tunnels and multi layers .After 6 months compared the clinical efficacy of two groups by evaluating the survival rate of autologous fat in augmentation mammoplasty and pre‐operative and postoperative breast volume ,the change of breast shape and patient satisfaction .Results Two groups of patients were successfully completed surgery ,and postoperative wound healed well .After 6 months ,in the centrifuge group and the static group the survival rate of autologous fat was 74 .42 ± 6 .35 and 65 .12 ± 5 .83 (P<0 .05) ,the satisfaction rate was 88 .37% and 76 .74%(P<0 .05) ,respectively .Conclusion The augmentation mammoplasty by injecting autologous fat granules in will not produce im‐mune rejection and surgical scar ,the breast shape is good and can be repeated without satisfactory ,until the desired effect is a‐chieved .The Centrifugal autologous fat can increase the survival rate of fat and patients′satisfaction ,which is suitable for clinical application .

Objective To analyze the effect of the rhinoplasty on body image in the patients receiving cosmetic surgery,to investigate the change of postoperative body image disturbance(BDD)and to analyze the influencing factors of preoperative BDD in order to provide a basis for the psychological health management and reference for the diagnosis and treatment of plastic surgery.Methods A prospective study was performed on 84 patients with rhinoplasty admitted to the Affiliated Friendship Aesthetic Plastic Surgery Hospital of Nanjing Medical University from January 2015 to March 2016.The general data were investigated.The Plastic Psychological State Self-rating Scale was adopted to evaluate the patient′s body image situation,which was reexamined at postoperative 1-3 months.Results The preoperative non-BDD accounted for 60.71％,the occurrence rate of BDD was 19.05％,the other mental disorders,mental diseases or nervous system disease which had no relation with the BDD accounted for 20.24％;the occurrence rate of postoperative BDD was significantly lower than that of preoperative BDD(P＜0.05),moreover the patients with non-BDD had no postoperative BDD occurrence.The scores of question 1-10 before operation in the BDD group were higher than those in the non-BDD group,the scores of question 1-4 after operation in the non-BDD group were decreased,the scores of question 1-4,6-10 in the BDD group were decreased,while the scores of question 1,7,9-10 in the BDD group were higher than those in the non-BDD group(P＜0.05).The proportion of preoperative rhinoplasty and plastic surgery in the BDD group was higher than that in the non-BDD group,the difference was statistically significant(P＜0.05).Conclusion The occurrence rate of BDD in the patients with rhinoplasty is higher,operation is conducive to lessen the BDD,moreover operation itself will not result in new BDD.

Objective To determine the vitamin D status in children with sepsis/severe sepsis in pediatric intensive care unit (PICU) in order to explor the association between vitamin D status and clinical outcomes,in turn to provide evidence for optimizing nutrition support.Methods It was a prospective,observational,multi-center study,carried out in patients with sepsis/severe sepsis from March 1,2013,to March 30,2014,in the PICUs of three tertiary-care children's hospitals.Total serum 25-hydroxy vitamin D [25 (OH) D] was measured by using an enzyme-linked immunosorbent assay at admission.The association of vitamin D status at admission with length of PICU length of stay,total hospital stay,in-hospital mortality,28-days mortality and costs were analyzed.Results A total of 194 patients includng 117 boys (60.3％)and 77 girls (39.7％) were enrolled.There were 96 patients with sepsis and 98 with severe sepsis.The mortality on discharge and 28 days were 6.7％ and 24.2％ respectively.The median vitamin D level was 9.79 ng/mL (5.32,18.46) at admission.Of them 77.8％ (151/194) had vitamin D deficiency and 50.5％ (98/194) had severe vitamin D deficiency.Patients with severe vitamin D deficiency,had higher mortality on discharge (P =0.011).Vitamin D status had no significant correlations with 28 days mortality,length of PICU stay,total hospital stay and costs.Conclusions More than three-quarters (77.8％) of children with sepsis/severe sepsis in PICUs had Vitamin D deficiency.Patients with severe vitamin D deficiency at admission had higher risk of mortality at discharge.