Objective To investigate the changes of serum leptin levels and the influential factors in maintenance peritoneal dialysis patients.Methods Seventy-six peritoneal dialysis patients were chosen at the time before,and 3 months,6 months,12 months,18 months and 24 months after they began the peritoneal dialysis therapy,to examine body mass index (BMI),triceps skinfold thickness (TSF),abdominal circumference,homeostasis model assessment of insulin resistance (HOMA-IR),the plasma lipid profile,and leptin in the same situation.Results For 24 months,these patients showed higher serum leptin level than the values before commencing peritoneal dialysis treatment (P ＜ 0.01).The level of leptin was positively correlated with the BMI(r =0.412,P ＜ 0.01),TSF(r =0.308,P ＜ 0.01),abdominal circumference(r =0.284,P ＜ 0.01),HOMA-IR(r =0.184,P ＜ 0.01) and TG(r =0.288,P ＜ 0.01),negatively corelated with the high-density lipoprotein cholesterol(HDL-C)(r =-0.285,P ＜ 0.01).Multiple logistic regression analysis showed that BMI (β =0.339,P ＜ 0.01),TGβ =0.157,P ＜ 0.01) and HDL (β =-0.126,P ＜ 0.05)were significant predictive factors for the changes of serum leptin levels.Conclusion Leptin maybe involve in the occurrence and the development of cardiovascular events like other metabolic parameters in peritoneal dialysis therapy.

Objective To investigate the relationship of sermn C-reactive protein(CRP), IL-18 and insu-lin resistance(IR) in women with polycystic ovary syndrome (PCOS). Methods 36 women with PCOS (study group) and 20 healthy women (control group) were recruited. Serum C RP, IL-18 and sex hormone concentration were tested. Oral glucose tolerance tests (OGTT) and insulin release tests (IR) were conducted in all cases. Body mass index (BMI), fasting glucose to insulin ratio(FGIR), 2-hour glucose to insulin ratio(G120/I120) and homeo-markedly higher T level, LH/FSH ratio , logCRP and IL-18 than control group[(2.77±1.30) nmol/L vs (1.21±0.67) nmol/L, (2.31±0.87) vs (0.58±0.32), (0.16±0.20) vs (-0.47±0.38), (0.21±0.08) μg/L vs vs (22.23±2.68 ) kg/m2, P<0.05] and fasting insulin (I0) concentration [(35.76±24.11) mU/L vs (11.90± 5.32) mU/L, P<0.05)], higher serum glucose (G60=(9.77±2.75) mmol/L vs (7.84±2.02) mmol/L, G120= (7.97+2.07 ) mmol/L vs (6.24±1.80) mmol/L, P<0.05), insulin (I60= (228.38±60.16) mU/L vs (132.46±60.15) mU/L,I120= (172.94±48.39) mU/L vs (90.63±39.79) mU/L,P<0.05 for each) after OGTT and IRT than control group. HOMA-IR increased and FGIR decreased more significantly in study group than controls group (HOMA-IR=(9.59±4.72)vs (3.06±0.82), FGIR=(0.11±0.04) vs (0.23±0.02), HOMA-IR (r=0.5 and 0.37,P<0.05), IL-18 was positively correlatrd with BMI and HOMA-IR (r=0.58 and 0.61, P<0.05). Partial correlation showed that logCRP was positively correlated with HOMA-IR (r=0.46, P< 0.05), but negatively correlated with FGIR and G120/I120(r=-0.54 and -0.48,P<0.05 for all) in test group. Conclusion IR exists in women with PCOS, and their increased serum CRP and IL-18 level shows positive correla-tion with IR,demonstrating that chronic inflammation may participate in the pathogenesis of PCOS, and may have correlation with insulin resistance.

Objective · To estimate correlation between coronary artery calcification score (CaCS) and prognosis of peritoneal dialysis (PD) patients.Methods · The clinically stable patients who had undergone PD for at least 2 months were recruited for this prospective and observational cohort study.Coronary artery calcification was assessed by multislice spiral computed tomography and was recorded according to the Agatston score. The patients were assigned to 3 groups, i.e. no calcification group (CaCS=0), low calcification group (0

Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)combined with per-cutaneous microwave ablation(MWA)in treatment of large-sized hepatic carcinoma.Methods A total of 84 patients with large-sized hepatic carcinoma were randomly and equally divided into the study group(n=42)and control group(n=42).TACE combined with MWA was carried out in the patients of the study group,while only TACE was performed in the patients of the control group.Results The effective rate of the study group and the control group was 71.4% and 42.8% respectively,and the difference between the two groups was statistically significant(P <0.05).In the study group,the survival rates at 6,12,18,24 months after the treatment were 88.1%,73.8%,52.3% and 33.3% respectively,while in the control group the survival rates were 76.2%,57.1%,30.9% and 9.5%respectively.There was no statistically significant differences in the postoperative complications between the two groups.Conclusion TACE combined with MWA appears to be an effective approach for the treatment of large-sized hepatic carcinoma.The effect of combined therapy is obviously superior to the only TACE.

Objective To investigate the pathogens,drug resistance and outcomes of continuous ambulatory peritoneal dialysis(CAPD) patients with peritoneal dialysis-related peritonitis in our peritoneal dialysis(PD) centers. Method Data including clinical manifestations,pathogens,treatment,outcome of 93 CAPD cases with peritoneal dialysis-related peritonitis in our peritoneal dialysis(PD) centers were retrospectively analyzed.Results Dialysate culture of 75cases was positive with a positive rate of 80.2％,including 45 cases of gram-positive cocci,21cases of gram-negative bacilli,2 cases of fungi and 5 cases of mixed infection.Coagulase-negative staphylococci were the most common gram-positive cocci.All the gram-positive cocci were sensitive to vancomycin,but the resistance rate to cefazolin was 60.0％ with an increasing tendence year by year.Resistance rate of gram-negative bacilli to ceftazidime was 46.1％.All the gram-negative bacilli were sensitive to imipenem.The withdraw rate of CAPD was 17.2％(16/93) because of peritonitis. Noobviousside-effectofperitonealadministrationofvancomycinwasfound.Conclusions Gram-positive cocci are major pathogens in CAPD-related peritonitis.Now cefasolin is not suitable for the empiric initial treatment.Peritoneal administration of vancomycin should be recommended for peritonitis caused by gram-positive cocci.

Objective To observe the effect of electroacupuncture at the beginning and ending points of bicipital muscle on the superficial electromyography (sEMG) of the spastic limb in hemiplegia.Method Forty patients with spastic hemiplegia after cerebral stroke were divided by the random number table into a group of electroacupuncture at the beginning and ending points (group A) and a group of electroacupuncture at antagonistic muscles (group B). The former selected Ashi points at the beginning and ending points of bicipital muscle, while the latter selected points at the antagonistic muscles [Tianjing (TE10), Qinglingyuan (TE11), etc.], to receive perpendicular puncturing. The needles were retained for 30 min, and the sEMG of bicipital muscles in resting state was detected after the removal of the needles. The spastic bicipital muscle was examined by sEMG prior to the acupuncture treatment, and respectively after 2-week and 4-week acupuncture treatment, and the detected parameters included root mean square (RMS) and integrated electromyography (IEMG).ResultThe EMG and IEMG declined gradually in the two groups after the acupuncture treatment; the intra-group comparisons of the RMS and IEMG values at three time points, e.g. prior to acupuncture treatment, after 2-week acupuncture treatment and after 4-weekacupuncture treatment, showed that the values changed significantly compared to those at the previous time point (P<0.05); the between-group comparisons showed that there were no significant differences in comparing the RMS and IEMG values regardless of different time points (P>0.05). The RMS and IEMG values presented same changing tendencies after 4-week acupuncture treatment in the two groups.ConclusionAcupuncture at the beginning and ending points and at the points on antagonistic muscles both can decrease the resting-state muscle tension in hemiplegia patients; sEMG is of certain significance in evaluating the treatment of hemiplegia.

Objective To investigate the significance of treadmill exercise test in male patients with coronary heart disease.Methods Two hundred and twenty-four male patients who diagnosed as coronary heart disease by coronary angiography were enrolled in this study,and treadmill exercise test were performed before and 1 month after coronary angiography.The coronary artery stenosis degree and scope were compared between two methods.Results In coronary angiography of 224 patients,the positive was 171 patients and negative was 53 patients.The single stenosis,double stenosis and triple stenosis was 87,55,29 patients.In treadmill exercise test of 224 patients,the positive was 143 patients and negative was 81 patients.The sensibility of treadmill exercise test compared the standard of coronary angiography was 81.3％,positive predictive value was 97.2％.Meanwhile in patients combined with hypertension or diabetic,treadmill exercise test found that the ST segment depression appeared earlier,persistence time longer.The persistence time and the number of down lead in double stenosis and triple stenosis was higher than that in single stenosis.Conclusion Treadmill exercise test is an important method in the diagnosis of coronary artery disease,and can preliminarily estimate the extent of coronary artery stenosis.

ObjectiveTo reveal status in quo of rehabilitation research according to rehabilitation periodical literature.MethodsMEDLINE and CBM are the retrieval databases during 1995—2002. ICD-10 is the main classification tool of central nervous diseases.ResultsThe percentage of rehabilitation literature is 1.32% on MEDLINE, 1.53% on CBM during 1995—2002. The ratio of rehabilitation literature is 1.67 between MEDLINE and CBM. The common study fields include stroke, paraplegia, hypertension, cerebral palsy, hemiplegia, Parkinson disease, epilepsy, and cerebral infarction, etc.The foreign study takes advantage in multiple sclerosis, and tetraplegia, etc. The fewer fields are neuromyelitis optica, arachnoiditis, and Huntington's disease, etc.ConclusionsThe study of central nervous disease rehabilitation is generally similar on some common CNS diseases, some foreign studies taking advantage.

Detrended fluctuation analysis (DFA) is fit for studies on the long-range exponential correlations of non-stationary time serial. In this paper, for elucidating the characteristics of different sleep stages, DFA is adopted to analyze the physiological data collected during sleep. The parameters such as electroencephalogram (EEG), R-R interval sequence and stroke volume (SV) are analyzed, and the scaling exponent a is calculated. The experimental results reveal that the values of a differ much in different sleep stages,that the rules of EEG and SV are alike, that alpha increases with the deepening of sleep, but in inverse for R-R interval sequence that alpha decreases with the deepening of sleep. These indicate that the method of DFA is practical in the analysis of physiological parameters.
Data Interpretation, Statistical ; Electrocardiography ; statistics & numerical data ; Electroencephalography ; statistics & numerical data ; Humans ; Polysomnography ; Signal Processing, Computer-Assisted ; Sleep Stages ; physiology

Osteoporosis (OP) is a systemic skeletal disease that primarily affects the elderly population, which greatly increases the risk of fractures. Here we report that Kindlin-2 expression in adipose tissue increases during aging and high-fat diet fed and is accompanied by decreased bone mass. Kindlin-2 specific deletion (K2KO) controlled by Adipoq-Cre mice or adipose tissue-targeting AAV (AAV-Rec2-CasRx-sgK2) significantly increases bone mass. Mechanistically, Kindlin-2 promotes peroxisome proliferator-activated receptor gamma (PPARγ) activation and downstream fatty acid binding protein 4 (FABP4) expression through stabilizing fatty acid synthase (FAS), and increased FABP4 inhibits insulin expression and decreases bone mass. Kindlin-2 inhibition results in accelerated FAS degradation, decreased PPARγ activation and FABP4 expression, and therefore increased insulin expression and bone mass. Interestingly, we find that FABP4 is increased while insulin is decreased in serum of OP patients. Increased FABP4 expression through PPARγ activation by rosiglitazone reverses the high bone mass phenotype of K2KO mice. Inhibition of FAS by C75 phenocopies the high bone mass phenotype of K2KO mice. Collectively, our study establishes a novel Kindlin-2/FAS/PPARγ/FABP4/insulin axis in adipose tissue modulating bone mass and strongly indicates that FAS and Kindlin-2 are new potential targets and C75 or AAV-Rec2-CasRx-sgK2 treatment are potential strategies for OP treatment.