Objective To investigate the mechanism of insulin resistance (IR) with coronary heart disease (CHD) by the relationship study between IR and the risk factors of CHD as well as the severity of coronary lesions. Methods One hundred and twenty three patients with at least one vessel ≥50% luminal narrowing were analyzed from our consecutive angiographic data base, excluding patients concomitant with hepatic, renal, pancreatic diseases, thyroid disorders and diabetes mellitus (DM) with insulin therapy. Oral glucose tolerance test (OGTT), blood lipid, plasma insulin were performed in all patients. Insulin resistance was assessed by homeostasis model assessment (HOMA) to investigate the relationship study between insulin resistance and the risk factors of CHD,severity of coronary lesions as well as the clustering of risk factors (hypertension, overweight, impaired glucose tolerance/DM, high serum triglycerides, low high density lipoprotein cholesterol). Results The level of IR was correlated with the levels of body mass index (BMI), fasting glucose, postprandial glucose, fasting insulin, postprandial insulin, hypertension, serum triglycerides, and high density lipoprotein cholesterol. Meanwhile the level of IR was associated with clustering of risk factors and the extent and the severity of coronary lesions. Conclusion Insulin resistance may be the basis for disease. In the primary and secondary prevention of CHD, we should not only treat syndromes but also reduce the level of IR.

Genes, Reporter ; Genetic Vectors ; Luciferases ; genetics ; Transcription, Genetic ; bcl-2-Associated X Protein ; genetics

Centering on the reform practice in Sanming featuring a synergistic reform in public health services,medical insurance and medicine production-circulation (Tripartite-sector reform below),this paper focused on the top-level design of the management system in such a reform and its synergistic operation mechanism.The authors probed into the main reasons for its grounding-breaking success and challenges,to pave way for their discussions on the reproducibility and sustainability of the reform.

Objective To observe the effects of strabismus surgery for treatment of concomitant exotropia and analyze the influential factors. Methods From 2000 to 2004, 95 patients hospitalized in our department underwent strabismus surgery and followed up for one week to 3 years. We retrospectively analyzed the deviation and superior sensory outcome at week 1 (95 cases) and week 6 (58 cases) after surgery. Results Seventy-four cases (82.11%) were completely corrected in one-week follow-up, and 46 cases (79.31%) in six-week follow-up. Nineteen cases (32.76%) recovered superior sensory. Conclusion Timely surgery of concomitant exotropia can improve not only the appearance but also the function of the eyes.

Objective To observe three-dimensional structure and biological features of rat acellular spinal cord scaffold prepared by sonic oscillation and chemical extraction in order to offer an ideal scaffold for spinal cord tissue engineering research.Methods Rat spinal cord underwent acellular treatment with sonic oscillation and chemical extraction (Triton X-100 at volume fracture of 2％ and sodium deoxycholate at volume fracture of 2％) (acellular spinal cord group).In contrast with spinal cord tissue of normal rats (control group),general morphology,histology and ultramicro three-dimensional structure of acellular spinal cord scaffold were observed and aperture size,factor of porosity,water ratio,enzymolysis ratio and stability in water solution of the scaffold were also detected.Results Acellular spinal cord group showed effective removal of original cell components with factor of porosity for (94.57 ±3.45) ％ and water content for (88.62 ± 1.0) ％,and satisfactory three-dimensional structure with average aperture of 46 μm.Scaffold showed gradual degradation in enzymolysis solution and enzymolysis rate reached (69.03 ± 2.19)％ at 20 hours.Besides,scaffold showed stepwise disintegration in double distilled water and hydrolysis rate was (62.55 ± 1.70) ％ at 8 days.While,normal spinal cord showed close structure,generous neurons and myelin sheath with factor of porosity for (0.04 ± 0.02) ％ and water content for (62.4 ± 1.5) ％,and unobvious pore structure under scanning electron microscope.Normal spinal cord were degraded gradually in enzymolysis solution and enzymolysis rate was (37.62 ± 0.9)％ at 20hours.In the meantime,normal spinal cord were disintegrated gradually in double distilled water and hydrolysis rate was (40.97 ± 0.81) ％ at 8 days.Conclusions Acellular spinal cord scaffold prepared by sonic oscillation plus chemical extraction achieves complete removal of cell components,intact extracellular matrix,and satisfactory results in three-dimensional network structures,factor of porosity and water content.Also,the scaffold meets theoretical demands of tissue-engineered spinal cord scaffold and is an ideal alterative for tissue-engineered spinal cord scaffold.

Objective To construct genipin-crosslinked rat acellular spinal cord scaffolds and evaluate their enzymatic degradation rate,biomechanical properties and cytotoxicity.Methods Rat spinal cord scaffolds were decellularized by chemical extraction and chemically crosslinked with 5 g/L genipin solution.Micro-structure of the uncrosslinked and genipin-crosslinked acellular spinal cord scaffolds were observed by HE staining and scanning electron microscopy and properties of pore size,porosity,water ratio,and degradation rate in 2.5 g/L trypsin enzyme solution were examined.Ultimate tensile strength and elastic modulus of normal rat thoracic spinal cord,uncrosslinked and genipin-crosslinked acellular spinal cord scaffolds were determined on Instron mechanical testing instrument.Rat bone marrow mesenchymal stem cells were cultured in lixivium of uncrosslinked and genipin-crosslinked acellular spinal cord scaffolds and MTT assay for relative cell growth rate was test to evaluate the cytotoxicity of scaffolds.Results The uncrosslinked and the genipin-crosslinked acellular spinal cord scaffolds possessed a similar three-dimensional mesh-porous structure with a mean pore diameter about 30 μm and a porosity over 80％,but there was a statistical difference between the two groups(P ＞ 0.05).Water ratio of genipincrosslinked scaffolds was (229.7 ± 12.5) ％,far lower than (283.4 ± 11.2) ％ of uncrosslinked scaffolds (P ＜ O.05) ; genipin-crosslinked acellular spinal cord scaffolds had lower weight loss at each time point than the uncrosslinked acellular spinal cord scaffolds (P ＜ 0.05),but the stability in trypsin,ultimate tensile strength and elastic modulus of acellular spinal cord scaffolds were significantly enhanced by genipin-crosslinking (P ＜ 0.05).Furthermore,no obvious cytotoxicity was observed in the uncroslinked and genipin-crosslinked scaffolds.Conclusions Rat acellular spinal cord scaffolds present no obvious change in structure after genipin-crosslinking,but there is significant improvement in the biomechanical properties and ability against enzymatic degradation and no marked cytotoxicity.Hence,the genipincrosslinked scaffolds are promising in tissue engineering for spinal injury.

Objective To evaluate the accuracy and reliability of O-arm-based thoracolumbar pedicle screw installation.Methods A retrospective review was conducted on 75 patients who had undergone thoracolumbar pedicle screw fixation assisted with O-arm navigation (navigation group,n =32) and C-arm fluoroscopy (fluoroscopy group,n =43) from March to October 2014.All the patients were assessed with X-ray and CT images after operation.Accuracy of screw installation in both groups was compared.In navigation group,screw directions were measured on the sagittal and axial images of intraoperative navigation and post-operative CT scanning to evaluate the concordance.Results In fluoroscopy group,a total of 206 pedicle screws were placed with the one-time success rate of 93.2％ and accuracy of 90.8％ for screw placement,and one misplaced screw (grade llⅢ) led to L3 nerve root symptom.In navigation group,a total of 226 pedicle screws were placed with the one-time success rate of 100％ and accuracy of 96.9％ for screw placement,and no screw was grade Ⅲ.Further,there were no significant differences in screw directions on the sagittal and axial images between intraoperative navigation and postoperative CT scanning (P ＞ 0.05).Conclusion O-arm navigation that provides high-resolution images and high precision improves the accuracy of thoracolumbar pedicle screw installation,and possesses good reliability.

In order to further study mouse embryonic stem cells(ES cells),lentiviral vector PLL-IRES-Nanog-Neo was constructed.Mouse ES cells overexpressed nanog by mediation of lentiviral were cultured on mouse fetal fibroblast feeders after 2 weeks under G418 media and examined according to gowth characteristics. Results were showed that 918 bp nanog fragments were expressed in mouse ES cells mediated by lentiviral vector PLL-IRES-Nanog-Neo,mouse nanog-ES cells were taken on mass-like image and positve with alkaline phosphatase staining and Oct4 and SSEA1 immunocytochemistry under no LIF condition in the media. It is concluded that mouse ES cells Elevated nanog gene expression by mediation of lentiviral were constucted and cultured.

All the examination results of anesthesia interns from 1996 to 2003 were analyzed.The content and criteria of examination in anesthesia intern which was formulated by our university was evaluated.The cause of deficiency reflected by examination results and problems existing in education were analyzed to improve clinic training for anesthesia intern and cultivate excellent anesthesia specialist.

Objective: To explore the value of dual energy CT lung perfusion imaging (DEPI) for diagnosing pulmonary embolism (PE) in comparison with CT pulmonary angiography (CTPA). Methods: There were 49 patients with suspected PE received DEPI scanning and 19 with CTPA conifrmed diagnosis were enrolled in this study. CTPA image was obtained by 80 kv data, and DEPI image was obtained by PBV software. The location, type of PE in CTPA image, and the location, shape of perfusion defect in DEPI were observed and compared by segment basis. The correlation and agreement of CTPA and DEPI for diagnosing PE were calculated and the un-agreement was analyzed. Results: A total of 380 segments were included for analysis. CTPA detected 162 segments of PE and DEPI detected 155 segments of perfusion defect or reduction, partial PE were mainly presented by perfusion defects as speckles, patches or without perfusion defect, and complete PE were mainly showed segmental or sub-segmental perfusion defects. CTPA and DEPI were correlated for PE diagnosis (χ2=305.5,P=0.000), the diagnostic agreement was 83.42% and KAPPA value was 0.659. Conclusion: The perfusion defect in DEPI is related to the degree and type of PE presented in CTPA, their combination is helpful for diagnosing PE.