Objective To investigate the fasting plasma insulin (FINS) and free fatty acid (FFA) in overweight or obesity patients with type 2 diabetes mellitns (T2DM) Methods 263 patients of T2DM were selected and divided into normal weight group(n = 108) and overweight or obesity group(n = 155) according to body mass index (BMI) , FINS level was detected by chemiluminescence method , and FFA level by colorimetry. 72 subjects without T2DM were taken as controls. Results FINS [(6.18±1.86) mIU/L vs (4.60±2.58) mIU/L, P < 0.01)] and FFA [(0.58±0.25) mmoL/L vs (0.35±0.14) mmoL/L,P < 0.01)] in T2DM group was significandy higher than that of control group. FINS in overweight or obesity group [(7.20±1.99) mIU/L] was higher than that in normal weight group[(5.31±1.21) mIU/L] and control group[(4.60±2.58) mIU/L] (P <0.01). In T2DM group,FiNS was positively correlated with duration(r =0. 334,P <0.01) ,BMI(r =0. 532,P <0. 01) and diastolic pressure (DBP) [r =0. 342 ,P <0.01). Conclusion The FINS level in overweight or obesity patients with T2DM is significantly higher compared to T2DM with normal weight T2DM,and the FFA level in patients of T2DM is significantly higher increased compared to control group,both of which participate in insulin resistence as well as the occurrence and development of T2DM.

Weanling Wistar rats were fed a modified AIN-76 diet ad libitum for 25 to 57 days, either copper-deficient (0.49mg/kg; CuD) or copper-adequate (6.44mg/kg;CuA). The effects of dietary copper deficiency on the enzymatic components of the primary free radical defense system-super-oxide dismutase (SOD), catalasc (CAT) and glutathione peroxidase (GSH-Px), lipoperoxides (LPO) and serum hemolysin were examined. The amount of LPO exhibited no significant change even though SOD activity decreased significantly in the tissues of CuD rats, which indicated that Cu-ZnSOD activity responded directly to copper status of the body but the compromises in the overall protection against free radicals were not evident. The profound reduction in scrum hemolysin in CuD rats suggests that humoral immune function is copper dependent. The results also suggest that as an index of evaluating copper nutriture CuZnSOD is more sensitive than hemoglobin to copper deficiency.

10.3969/j.issn.2095-4344.2013.25.026

OBJECTIVE: To optimize the formulation of metoprolol tartrate sustained-release tablets in compound hydrochlorothiazide double layer tablet.METHODS: The formulation of metoprolol tartrate sustained-release tablets was optimized using orthogonal experiment with release rate in vitro as index,total amount of HPMC and carbomer (A) and its ratio (B),amount of MCC (C) and the concentration of PVP ethanol solution (D) as factors.RESULTS: The optimal formulation was as follows: A=30%,B=1 ∶ 2,C=20% and D=5%.Accumulative release rate of 3 batches of metoprolol tartrate sustained-release tablet prepared by optimized formulation were 25%～45% within 1 h,40%～75% within 4 h,more than 75% within 8 h and more than 90% within 24 h.CONCLUSION: Optimized formulation of metoprolol tartrate sustained-release tablets is reasonable and simple.

Objective To observe the changes of melanin granules in superficial corneocytes in vitiligo lesions after irradiation with narrow-band ultraviolet B (NB-UVB) by using an adhesive tape stripping technique.Methods Vitiligo lesions were selected from 6 patients and irradiated with NB-UVB every other day for 31 sessions.Superficial corneocytes were obtained by an adhesive tape stripping technique from the vitiligo lesions and perilesional normal skin before every treatment.The morphology,distribution and color of melanin granules were observed after Masson-Fontana silver staining.The percentage of area occupied by melanin granules in superficial corneocytes were calculated by using the Image-Pro Plus 6.0 software.Statistical analysis was conducted by the SPSS11.5 software.Results There were still a few superficial corneocytes containing melanin granules remaining in the vitiligo lesions before treatment.The percentage of area occupied by melanin granules was (5.31 ± 4.12)％ before treatment,(6.24 ± 2.65)％ after 10 treatment sessions,(10.14 ± 5.73)％ after 20 sessions,and (13.05 ± 6.17)％ after 30 sessions,with significant differences between these time points (F =4.334,P ＜ 0.05).Multiple comparisons revealed a significant increase in the percentage of area occupied by melanin granules after 30 treatment sessions compared with those before treatment and after 10 treatment sessions (both P ＜ 0.01 ).The morphology and color of melanin granules in repigmented lesions after treatment differed from those in perilesional normal skin before treatment.Conclusion The adhesive tape stripping technique may serve as a useful tool for the evaluation of repigmentation in vitiligo lesions after phototherapy.

Radical resection is crucial in the surgical treatment of adenocarcinoma of the body and tail of pancreas.It usually refers to negative resection margin and dissection of regional lymph nodes.In recent reports,the definition of R0 margin has been updated,and radical antegrade modular pancreatosplenectomy (RAMPS),which was first described by Strasberg et al,contributes to achieving negative tangential margins.In some cases,extended radical resections were adopted in an attempt to achieve R0 margin.However,it would increase operation related morbidity and mortality,which should be taken into account before the procedure.Lymph nodes metastasis is an important prognostic factor.Extended lymph nodes dissection does not seem to bring survival benefits,while itg helpful in assessing the tumor stages and patients' prognosis.Laparoscopic distal pancreatectomy (LDP) has been applied in the treatment of ductal adenocarcinoma of the pancreas in reports with small sample sizes.But it remains controversial whether LDP is superior comparing to conventional open methods in regards to oncological outcomes.Curently,surgery is the promising method that may cure adenocarcinoma of the body and tail of pancreas.Highlighting radical resection will bring more survival benefits to patients.

Objective To investigate the surgical management of scoliosis in neurofibromatosis Ⅰ type. Methods Since 1983, the results of surgical intervention of 31 consecutive patients for scoliosis in neurofibromatosis were reviewed. There were 19 males and 12 females. The mean age of the patients was 15.4 years (range, 5 to 25 years). The type of curve in scoliosis included thoracic curve in 23 patients, lumbar curve in 3 and thoracolumbar curve in 5. There were 6 cases of thoracic curves associated with kyphosis. The mean Cobb angle of scoliosis was 85.9? ranging from 45? to 145?, and the mean Cobb angle of kyphosis was 81.3? ranging from 43? to 120? before operation. The surgical methods included posterior operation in 17 patients, anterior operation in 2, and combination of anterior and posterior in 12. The instrumentation used for internal fixation included Harrington rod in 7 patients,Luque rod in 3, combination of Harrington and Luque rod in 5 patients, CD in 4 patients, CDH in 3 patients,TSRH in 7, and PRSS in 2, 10 cases of whom only single rod fixation were used. Results The patients were followed up for an average of 9.4 years (range, 1-18 years). The correction rate of Cobb angle in scoliosis was 33.4% in scoliosis, and 39.6% in kyphosis postoperatively. The complications of the group consisted of Luque rod breakage in 1 patient, Harrington rod breakage in 1, Harrington rod and Luque wire breakage in 1,nonunion of bone graft and pseudarthrosis in 4, curve aggravation in 1. One patient underwent revision for three times because of recurrent hook dislodgement. Conclusion Scoliosis in neurofibromatosis should be operated early, sufficient bone graft and the solid instrumentation for internal fixation are required.

Objective The study was to probe into the causes and strategies of decompensation after operation in adolescent idiopathic scoliosis in order to reduce the operative mistakes and be aware of pitfalls in scoliosis surgery.Methods From July1997to December2001,174patients underwent the operation of three-dimensional correction of adolescent idiopathic scoliosis,ten of them developed postoperative decom-pensation.Other four patients with postoperative decompensation were referred to our hospital,who received the primary operation for idiopathic scoliosis at the local hospital.In all,fourteen patients with decompensa-tion were retrospectively reviewed including3male and11female cases aging from12to23years(range,15.7years).The criteria of postoperative decompensation was defined as trunk shift more than2mm,shoul-der tilting,aggravated distal lumbar rotation in coronal plane,the plumb line of center of C 7 deviating the from the posterior edge of S 1 and kyphosis of thoracic-lumbar junction more than10degree in sagittal plane.Results The analysis was made depending on preoperative and postoperative X-ray films,the causes of de-compensation after surgery included classification error,inappropriate fusion level,over correction for tho-racic curve and insufficient knowledge of lumbosacral hemicurve in this group.According to the patientssubjective symptoms and decompensation conditions,ten of the patients were treated surgically,which in-cluded re-fusion and fixation for3patients,fusion level extension for6patients and fusion of the upper tho-racic curve after removing major thoracic curve instrumentation for one patient.The other four patients re-ceived conservative therapy with brace.The patients were followed up from1to3years(average,18.9months),except one case followed up to6months.Twelve patients regained spinal balance;two patients re-mained more than20mm trunk shift.Conclusion Although operative treatment is frequently used for idio-pathic scoliosis,it is important to recognize the necessity for operative intervention,indication for surgery.The adolescent idiopathic scoliosis should be operated according to the curve type and flexibility,the appro-priate fusion level and operative procedures can contribute to lessen the postoperative decompensation.If postoperative decompensation occurs,therapeutic decision should be made according to subjective symptoms and the decompensation type of the patients.

Purpose: To explore the autocrinism of vascular endothelial growth factor ( VEGF) in human hepatocellular carcinoma cell and its significance. Methods: The expression of VEGF receptors was analyzed by reverse transcription-polymerase chain reaction (RT-PCR) in human hepatocellular carcinoma cell lines SMMC7721, HHCC and HepG2 in vitro. The expression of VEGF in human hepatocellular carcinoma cells was inhibited by synthetic antisense oligodeoxynucleotide (ODN). Phenotypic alterations in human hepatocellular carcinoma cells by antisense reduction of VEGF expression were observed. And the alterations for expression of VEGF receptors in human hepatocellular carcinoma cell membranes were analyzed by flow cytometry. Results: Flt-1 was expressed faintly in SMMC-7721 cell whereas KDR was expressed in HHCC cell and HepG2 cell in vitro. Compared to control, antisense ODN against VEGF inhibited HHCC cell proliferation in vitro in a dose-dependent manner and had no effects on SMMC-7721 cell and L929 cell. When the concentration of antisense ODN was 2.5 ?mol/L,5 ?mol/L and 10 ?mol/L, the proliferation of HHCC cell was inhibited by 26%, 41 % , and 50% respectively. Compared with control, flow cytometry analysis showed a decrease in cell number in S phase and a pre-apoptosis peak in HHCC cell treated by antisense ODN. There was no alteration of cell cycle in SMMC-7721 cell. The positive rate of KDR expression in HHCC cell membrane was 19. 2%, 29. 8% and 31. 2% in the antisense ODN, sense ODN and control groups, respectively. The expression of KDR in HHCC cell membrane was markedly inhibited by antisense ODN against VEGF compared with the control group, as measured by flow cytometry. There was no alteration for expression of Flt-1 in SMMC-7721 cell membrane. Conclusions: VEGF produced by human hepatocellular carcinoma cells acts directly upon human hepatocellular carcinoma in an autocrinal manner and may promote the proliferation and differentiation of human hepatocellular carcinoma cells via the activation of the KDR-dependent signaling pathway.

Objective To evaluate the anatomical structure of bone in the formation of acetabular teardrop shadow. Methods The acetabular teardrop shadow of the X ray plain film in 100 children and 300 adults, and of CT in 43 cases were analysed 、measured and compared. Results In children, teardrop shadow appeared “U”in 80 00%, 14 00% in teardrop, 6 00% in line. In adult teardrop shadow appeared “U”in 41 33%, 53 33% in teardrop, 5 34% in line. There were significant differences between children and adult in the frequency of “U” and teardrop (? 2=43 34, P