Objective To investigate the relationship between alterations in the corneal innervation observed by laser confocal microscopy and peripheral neuropathy severity in the patients with impaired glucose tolerance (IGT).Methods A total of 70 patients with IGT were consecutively enrolled into the study.Among them,30 patients were diagnosed as peripheral neuropathy (IGT-PN),40 patients without peripheral neuropathy (IGT-NPN).Fifty age-matched healthy subjects were also studied.Corneal subbasal nerves were investigated by laser confocal microscopy.Results Corneal nerve fiber length (17.1 ±4.9) vs (14.0±3.8) mm/mm2; t=13.484,P＜0.05),newe branch density ((53.1 ±18.8) vs (36.2±11.5) mm/mm2 ; t =9.369,P ＜ 0.01) and nerve fibre tortuosity ((2.07 ± 0.76) vs (0.88 ± 0.55) levels,t =12.957,P ＜0.05)were significantly increased in IGT-NPN group when compared with control group,but nerve fibre density had no difference.Nerve fiber length,nerve branch density and nerve fibre density were significantly decreased in IGT-PN group compared with control group and IGT-NPN group,while NFT was significantly increased in IGT-PN group.Conclusions Patients with impaired glucose metabolism show alterations in corneal innervations before diagnosed with diabetes mellitus or peripheral neuropathy.It indicates that corneal confocal microscopy can be used for early diagnosis of diabetic peripheral neuropathy.

Objective:To assess the impacts of feeding type and non-nutritive sucking activity on occlusion in deciduous dentition in WeiFang city.Methods:The occlusion of 958 children aged 3 -5 years old in WeiFang city and their feeding types as well as the non-nutritive sucking habit during the first 1 2 months after birth were investigated by questionaire study.Data were statistically ana-lysed.Results:The prevalence of malocclusion in non-nutritive sucking habit group and non-habit group was 42% and 22% respec-tively(P =0.000 2).The type of feeding did not have effect on occlusion and openbite.The prevalence of openbite in the children with sucking habit and in those without habit was 17% and 4% respectively(P <0.000 1 ).The prevalence of posterior crossbite in the chil-dren with bottlefeeding and those with breastfeeding was 1 1 % and 4% respectively(P =0.000 2).The prevalence of posterior crossbite in the children with sucking habit and those without habit was 9% and 4% respectively(P =0.036 7).Conclusion:Non-nutritive sucking habit rather than feeding type in the first 1 2 months after birth is the main risk factor of malocclusion,breastfeeding is the pro-tective factor to occlusion.

Objective To explore the diagnostic value of corneal confocal microscopy in the early small fibre neuropathy (SFN).Methods A total of 45 patients with small fibre neuropathy and 50 age-matched healthy subjects undertook a neurological evaluation,neurological deficits score (NDS),sural nerve conduction velocity,contact heat evoked potential (CHEP) and corneal confocal microscopy (CCM) to quantify small nerve fibre pathology.Four parameters including nerve fiber length (NFL),nerve branch density (NBD),nerve fiber density (NFD) and nerve fibre tortuosity (NFT) were calculated from the observation of corneal confocal microscopy.Results Compared with the control group,significantly decreased NFD and NBD were found in the SFN group [(42.00 ±25.26)/mm2 vs (72.38 ± 14.09) /mm2 ;(31.93 ± 13.21)/mm2 vs (46.24 ± 11.48)/mm2 ; with all P ＜ 0.05],while NFT were significantly increased in the SFN group [(2.48 ±0.87) levels vs (0.88 ±0.56) levels,P ＜0.001].The neurological deficits score was correlated with NFT,NFD and NBD (r =0.782,-0.376,-0.504 ; with all P ＜ 0.001).Conclusion CCM is a new and sensitive noninvasive clinical technique that may be used to detect early small fibre nerve damage in patients with SFN.

OBJECTIVE:To study the anti-hepatic fibrosis effects of Yidu tiaogan mixture on rats and its mechanism. METH-ODS:60 SD rats were randomly divided into normal group,model group,colchicine group(positive control,0.2 mg/kg)and Yi-du tiaogan mixture low-dose,medium-dose and high-dose groups(2.7,5.4,10.8 mL/kg). Except for normal group,liver fibrosis model was induced in other groups,and they were given relevant medicine intragastrically during modeling,once a day,for 8 weeks. Serum levels of ALT,AST,HA,PCⅢ,CⅣ,TIMP-1,MMP-1,MMP-2,MMP-13,TGF-β1 and TNF-α and the levels of Hyp,SOD,GSH-Px,CAT,MDA,TGF-β1 and TNF-α in liver tissue were detected in rats. RESULTS:Compared with normal group,the serum levels of ALT,AST,HA,PCⅢ,CⅣ,TIMP-1,MMP-2,TGF-β1 and TNF-α were increased significantly in model group,while the serum levels of MMP-1 and MMP-13 were decreased significantly(P<0.05);the levels of Hyp,TGF-β1, TNF-α and MDA in liver tissue were increased significantly,while the levels of SOD,GSH-Px and CAT were decreased signifi-cantly(P<0.05). Compared with model group,the serum levels of ALT,AST,HA,PCⅢ,CⅣ,TIMP-1 and TNF-α as well as the levels of Hyp,TGF-β1,TNF-α and MDA in liver tissue were all decreased significantly of rats in Yidu tiaogan mixture medi-um-dose,high-dose and colchicine groups(P<0.05);the serum levels of MMP-1 and MMP-13 as well as the level of CAT in liver tissue were increased significantly in Yidu tiaogan mixture high-dose group and colchicine group(P<0.05),while the serum levels of MMP-2 and TGF-β1 were decreased significantly(P<0.05). There was no statistical significance in above indexes in Yidu tiao-gan mixture low-dose group (P>0.05). CONCLUSIONS:Yidu tiaogan mixture exerts protective effects on liver fibrosis of rat through regulating TIMP/MMP balance,suppressing oxidative stress,decreasing the level of TGF-β1 and reducing deposition of ex-tracellular matrix in liver.

Objective To explore the optimal timing of termination of pregnancy,we analyzed the different gestational age in repeat cesarean delivery and maternal and neonatal outcomes.Methods This was a retrospective study.The information of cesarean sections was collected from maternal obstetric records in the electronic medical recording system of the First Affiliated Hospital of Chongqing Medical University from June 1,2011 to June 30,2013,and women with intrauterine viable singleton pregnancies delivered after 37 weeks of gestation without prenatal complications were selected.They were divided into five groups with different gestational weeks.Maternal general information,perioperative outcome and rate of neonatal adverse event were analyzed with one way ANOVA analysis and Chi-square test.Results A total of 579 cases of elective repeat cesarean at term were performed.The ratios of cesarean section prior to 39 and 39-39+6 weeks of gestation were 64.6％ (374/579) and 29.0％ (168/579),respectively.No fetal,neonatal or maternal death occurred.There were no statistically significant differences in the termination of pregnancy at 37-37+6 weeks,38 38+6 weeks,39-39+6 weeks,40 weeks and ≥ 41 weeks between the two time intervals for cesarean section (P＞0.05).There were statistically significant differences in the length of hospitalization [(4.9±3.0),(4.3 ± 1.3),(4.3 ± 1.0),(4.5± 1.2) and (4.0±0.7) d,respectively; F=2.849,P＜0.05].No significant difference was observed in the maternal BMI,placental membrane residue,maternal perioperative bleeding,premature rupture of membrane (PROM),intensive care unit (ICU) admission and uterine resection (P＞0.05).There were statistically significant differences among the five groups in neonatal weight [(3 082.9±479.2),(3 318.1 ±390.8),(3 415.7±431.1),(3 630.5±475.2) and (3 334.0±242.5) g,F=13.798] and length [(48.8± 1.5),(49.3± 1.5),(49.6± 1.5),(50.0± 1.5) and (47.8±3.9) cm,F=7.460; both P＜0.05].One min and 5 min Apgar scores also showed statistically significant differences [1 min:(9.7±0.7),(9.8±0.6),(9.8±0.4),(9.7±0.5) and (8.8±2.7) ; F=4.432; 5 min:(9.9±0.3),(10.0±0.3),(10.0±0.2),(10.0±0.2) and (9.2± 1.8),F=9.625; all P＜0.05].The overall rates of neonatal adverse events,including the admission to neonatal intensive care units (NICU),the rates of cardiopulmonary resuscitation or ventilator therapy,asphyxiation,as well as the length of stay in NICU ≥ 5 d among the five groups also showed statistically significant differences [overall:5.4％ (5/93),1.8％ (5/281),0.6％ (1/168),0.0％ (0/32) and 2/5,x2=16.812;NICU:3.2％ (3/93),1.1％ (3/281),0.0％ (0/168),0.0％ (0/32) and 1/5; x2=1 1.294; cardiopulmonary resuscitation or ventilator therapy:2.2％ (2/93),0.7％ (2/281),0.0％ (0/168),0.0％(0/32) and 1/5,x2=10.584; asphyxiation:1.1％ (1/93),0.7％ (2/281),0.0％ (0/168),0.0％ (0/32) and 1/5,x2=9.637; NICU ≥ 5 d:3.2％ (3/93),1.1％ (3/281),0.0％ (0/168),0.0％ (0/32) and 1/5,x2=1 1.294; P＜0.05].The risks of neonatal adverse outcomes in delivery at 37-38+6 weeks were:OR=1.1(95％CI:1.0-2.1) at 37 37+6 weeks,OR=1.3 (95％CI:0.9-1.9) at 38-38+6 weeks,compared with delivery at 39-39+6 weeks.Conclnsions The percentage of repeat cesarean delivery prior to 39 weeks of gestation is high in our hospital,early termination of pregnancy would not reduce the maternal perioperative adverse outcome,but may increase the risk of neonatal adverse events.Taking into account the maternal benefit,we suggest 39 39+6 weeks of gestation as the best time of elective repeat cesarean in order to reduce the risk of neonatal adverse events.

BACKGROUND: Nerve growth factor (NGF) and brain-derived neurotrophic factor(BDNF) are very important to the survival and proliferation of nerve cells. In the patients with Alzheimer disease (AD), the levels of NGF and BDNF are low.OBJECTIVE: To investigate whether acidic peptide can stimulate rat astrocytes to secrete NGF and BDNF.DESIGN: A randomized control animal experiment.MATERLALS: The experiment was finished in the First Laboratory of Institute of Biopeptide, Zhengzhou University; Cellular Culture Center,School of Basic Medical Sciences of Zhe ngzhou University from September 2003 to May 2005. Fifteen neonatal SD rats within 2 days after birth were selected.METHODS: ① The cerebral cortex of the neonatal SD rats was removed under sterile condition, the astrocytes were isolated and cultured, and then identified with the glial fibriliary acidic protein immunohistochemical staining. ② The cultured astrocytes were randomly divided into six group:blank control group, serum control group, positive control group and acidic peptide treated groups. No treatment was given in the blank control group,serum of 0.2 in volume fraction and 1 000 U/mL interferon were added in the serum control group and positive control.group, 37.5, 75 and 150 mg/L acidic peptides were added in the acidic peptide treated groups respectively. ③ The astrocytes of the 2nd generation, which covered the whole bottom of bottle, were digested to single cell suspension, and then inoculated to three 12-well plates equally at 5×105 /mL. The survival rate and the contents of NGF and BDNF in the supernatant of each group were determined at 24, 48 and 72 hours respectively.MAIN OUTCOME MEASURES: ① Cell numbers and survival rates at different culture time-points; ② Effect of acidic peptide on the proliferation of astrocytes in rats; ③ Changes of NGF and BDNF in the supernatant of astrocytes at different culture time-points.RESULTS: ① As compared with the blank control group, the cell numbers and survival rates at 24, 48 and 72 hours were obviously increased in the acidic peptide groups treated with 75 and 150 mg/L (P＜0.05, 0.01,0.001), but not obviously increased in the acidic peptide group treated with 37.5 mg/L. ② As compared with the blank control group, the rates of proliferation in the acidic peptide groups treated with 37.5, 75 and 150 mg/L were all significantly increased (17.5%, 45.5%, 72.5%, P＜0.001). ③ As compared with the blank control group, the absorbance (A) values of NGF in the supernatant at 24, 48 and 72 hours were all markedly increased in the acidic peptide groups treated with 37.5, 75 and 150 mg/L (P＜0.001),and the A values of BDGF in the supernatant at 48 and 72 hours were significantly increased (P＜0.05, 0.01).CONCLUSION: Acidic peptide can increase the secretions of NGF and BDNF of rat astrocytes to different extent.

ObjectiveTo evaluate the surgical techniques and 2-year follow-up results of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF).MethodsFrom September 2006 to October 2008,54 patients with single-level lumbar degeneration disease were treated by Mast Quadrantassisted modified TLIF.Under the guidance of C-arm,the Mast Quadrant's retractor was placed and the lower articular process of the upper vertebrae and 1/2-2/3 of the lamina,flavum ligament and hyperplastic cohesive part of the lower articular process were removed,the nerve roots and the central canal were decompressed.After cleaning up intervertebral disc space,bone grafting and pedicle screw fixation were achieved.Visual analogue scale(VAS) and Oswestry disability index(ODI) results,as well as the fusion rate at the last follow-up were analyzed.ResultsAll patients were treated by Mast Quadrant-assisted modified TLIF,in which 51 patients were followed up for 2 years.An average operating time was(178.7±63.2) min,and an average blood loss was (224.2±136.5) ml; an average postoperative drainage loss was (117.2±91.4) ml,and an average postoperative stay was(5.8±3.6) d.There were statistic significances between pre- and post-operative ODI and VAS scores,respectively.At last follow-up,51 patients were achieved radiographic fusion without internal fixation failure and other complications.ConclusionMast Quadrant-assisted modified TLIF had a good vision,was relatively safe and easy to be acceptable by surgeons,and which had a good clinical results for the patients with single-level lumbar degenerative disease.

Objective Objective To investigate the relationship between choroidopathy and integrated backscatter(IBS) of choroid in diabetes mellitus(DM) patients.Methods Eighty DM patients of 158 eyes were divided into 3 groups by the course of diabetic retinopathy(DR)-DM patients without DR group,DM patients with the background DR,DM patients with the proliferative DR.80 normal persons of 160 eyes were the control group.Their IBS values were measured on nose side,temple side and middle side of choroid by HP Sonos 5500,and the correction IBS values(IBS％) were calculated.Results With the deterioration of DR,the IBS and IBS％ of choroid increased.The statistical significance difference were found in various groups(P ＜ 0.01).Conclusions With the deterioration of diabetic choroidopathy,the IBS and IBS％ increased.The IBS technique is useful method to assess the diabetic choroidopathy.

Objective To investigate the clinical characteristics of adult patients with community acquired pneumonia (CAP) caused by acute Mycoplasma pneumoniae (MP) infection, and provide evidence for early identification of MP infection. Methods A prospective, multicenter and cross-sectional study was conducted. 452 adult patients with CAP admitted to Beijing Friendship Hospital, Beijing Guangwai Hospital and Air Force General Hospital from August 2011 to October 2015 were enrolled. The diagnosis of adult MP infection was confirmed by the combined application of double serum antibody titer and MP-DNA nested polymerase chain reaction (PCR) through testing serum and throat swab samples from patients to identify acute infections, past infections, pathogen carrying, and non-MP infection. The clinical characteristics of patients with acute MP infection were summarized by analyzing the baseline data, clinical parameters and chest imaging findings in patients with non-MP infection and acute MP infection. Results Of 452 enrolling patients with CAP, 288 patients (63.7%) suffered from MP infection, and 164 patients (36.3%) with non-MP infection. There were 56 patients (12.4%) with acute infection, 10 patients (2.2%) with past infections, 222 patients (49.1%) with pathogen carriers in MP infective patients indicating susceptible to MP in adult patients. There were no significant differences in gender, age, fever extent, duration of fever, sputum production, shortness of breath, rales, underlying diseases, etc. between non-MP infection and acute MP infection patients, which suggested that the baseline data of the two groups were equilibrium. The acute infection rates of MP in summer and autumn (43.9% and 43.5% respectively) were more than those in spring and winter (13.3% and 12.3% respectively). It was shown by laboratory examination results that serum cardiac troponin T (cTnT) increased significantly in acute MP infectious patients more than that in non-MP infection patients (30.4% vs. 9.8%, P < 0.01), which indicated that patients with acute MP infection were more likely to have myocardial injury. While there were no significant differences in blood routine, blood electrolytes, blood glucose, as well as heart, liver and kidney function between the two groups. It was shown by chest imaging that the diffuse lesions (57.1% vs. 37.2%), mediastinal lymphadenopathy (60.7% vs. 37.8%) were less founded in the middle lobe of the right lung (12.5% vs. 32.9%), which were the main manifestations in patients with acute MP infection as compared with non-MP infection patients with statistical difference (all P < 0.01). There were no significant differences in the chest imaging performances of pulmonary ground glass shadow, lobar and segmental consolidation, patch shadow, a shadow, acinar nodules, grinding glass density nodules, the photic zone, hilar lymphadenopathy and pleural effusion occurrence between the two groups. Conclusion Adult CAP patients are easy to carry MP, myocardial damage is a common complication in acute MP infectious patients which are characteristic of image findings of diffuse lung disease, mediastinal lymphadenopathy and less founded in the middle lobe of the right lung.

Objective:To analyze the differentally expressed long non-coding RNA (lncRNA) among mice of different ages and explore the mechanism of kidney aging.Methods:Male C57BL/6 mice aged 3-month-old ( n=5), 12-month-old ( n=5) and 24-month-old ( n=5) (each weighting about 25 g) were randomly selected. PAS staining, Masson staining and senescence associated β-galactosidase (SA-β-gal) staining were used to detect the pathology and cell senescence of mice kidney. High throughput sequencing was performed to detect the differentially expressed lncRNA and their fragments per kilobase million. Real-time quantitative PCR was used to verify the differentially expressed lncRNA. Competitive endogenous RNA (ceRNA) network, which consisted of lncRNA, miRNA and mRNA was built. GO and KEGG enrichment analysis method were used to predict the biological function of differentially expressed lncRNA. Results:PAS staining and Masson staining showed the development of kidney fibrosis, and SA-β-gal staining positive region was increased significantly as age increased. There were 938 known lncRNA and 542 novel lncRNA differentially expressed among different ages' mouse kidney. Compared with 3-month-old mice, 33 lncRNA were up-regulated and 43 lncRNA were down-regulated in 12-month-old mice. Compared with 3-month-old mice, 130 lncRNA were up-regulated and 91 lncRNA were down-regulated in 24-month-old mice. Compared with 12-month-old mice, 36 lncRNA were up-regulated and 22 lncRNA were down-regulated in 24-month-old mice. The results of qRT-PCR about verified 10 lncRNAs with larger differential expression multiples and higer expression levels were consistent with the sequencing data. GO enrichment analysis showed that the target genes of lncRNA differentially expressed in the three groups were mostly located in the nucleus and cytoplasm, and might play a role by binding to proteins or participate in various protein phosphorylation, cell cycle, transcription, transcription regulation and other processes. KEGG enrichment analysis showed that the target genes of lncRNA differentially expressed in the three group were significantly enriched in Rap1 signaling pathway, FOXO signaling pathway and MAPK signaling pathway, which were closely related to kidney aging.Conclusion:There are significant differences in expression of lncRNA among the kidney of different ages mice, which are involved in the occurrence of renal senescence.