BACKGROUND:More than 10 kinds of lipid metabolism-related genes have been found, and endocrine dysfunction mediated by these genes is an important pathological basis for the occurrence and development of insulin resistance. OBJECTIVE:To investigate the effects of metformin on serum lipid profiles and the expression levels of various genes associated with insulin resistance, as well as the histopathological changes of the liver and pancreas in rats with type 2 diabetes melitus. METHODS:A type 2 diabetes mellitus rat model was established by feeding a high-fat diet to the rats for 4 weeks, combined with the intraperitoneal injection of streptozotocin (35 mg/kg). In the meanwhile, metformin was administered orally (400 mg/kg?d) (model group) or nothing (control group). Semi-quantitative RT-PCR, histopathological and biochemical examinations were then performed. RESULTS AND CONCLUSION:Metformin improved the symptoms of insulin resistance by normalizing the serum lipid profiles in the diabetic rats. Furthermore, metformin upregulated the expression levels of insulin receptors and genes associated with lipid metabolism, including acyl-CoA oxidase, carnitine palmitoyl transferase-1 and peroxisome proliferator activated receptor-α. In addition, metformin downregulated the expression levels of fetuin-A and retinol binding protein-4, and improved the expression of perilipin that had been reduced in the type 2 diabetes mellitus rats. Metformin was shown to induce positive signaling for insulin and the regeneration of pancreaticβcells in the pancreas. These results suggest that metformin ameliorates the insulin resistance induced by type 2 diabetes mellitus via regulating the expression levels of fetuin-A, retinol binding protein-4, perilipin and various genes associated with lipid metabolism.

0. 05). Conclusions Panipenem and betamipron are effective and safe drugs in the treatment of serious in-hospital infection in elderly patients.

Objective To assess the role of endoscopic ultrasound guided fine needle aspiration (EUS-FNA)for diagnosis of gastrointestinal tract lesions.Methods Sixty-eight patients underwent endoscopic uhrasonagraphy and EUS-FNA between May 2007 and Dec.2008.The result of cytology and/or pathology was compared with that of surgical finding and follow-up study.Results EUS-FNA was successfully performed on 62 patients with lesiorm in oesophagus(4 eases),stomach(19 case),rectum(19 cases),liver(3 case),mediastinum(4 cases)and lymph node(13 cases),and had a successful rate of 91.18%(62/68).Among them,the lesions in 40 patients(64.52%)were cytologically confirmed.The lesions in 10 out of 22 patients(35.48%)were pathologically confirmed.Compared with the results of pathology and long-term followe-up study,the sensitivity,specificity and positive predictive value of EUSFNA in diagnosis of lesions in gastrointestinal tract was 85.48%,100.00%and 90.91%,respectively,The positive predictive value and negative predictive value was100.00%and 57.14%,respectively.Conclusion EUS-FNA is a safe,effective and accurate method for diagnosis of lesions in gastrointestinal tract,and has an important role in cytological diagnosis.

Objective To explore the diagnostic value of serum cystitis C(CysC),urinary transferrin (UTRF)and urinary α1 microglobulin(α1MG)in the diagnosis of early diabetic nephropathy(DKD).Methods Totally 165 patients with diabetic mellitus treated in the hospital from January 2016 to January 2017 were selected,and then assigned to diabetic mellitus group(DM group)and diabetic kidney disease group(DKD group)based on urinary albumin excretion rate(UAER).83 healthy people were enrolled and assigned to con-trol group.The level of serum CysC,serum creatinine(SCr)and blood urea nitrogen(BUN)were detected by automatic biochemical analyzer,the level of UTRF,α1MG and microalbuminuria(MALB)were detected by lmmunoturbidimetry and then compare the variance in each group.Results Compared with the control group and DM group,the level of serum CysC,UTRF,α1MG and MALB were significantly increased in DKD group (P<0.05);The level of SCr and BUN in DKD group were increased but had no statistical significance com-pared with DM group(P> 0.05).Meanwhile,the positive detection rate of serum CysC,UTRF and α1MG were significantly higher than SCr and BUN(P<0.05).Serum Cys C,UTRF and α1MG showed positive cor-relation with MALB,SCr and BUN,the level of serum Cys C also showed a positive correlation with α1MG. The sensitivity of serum Cys C,UTRF and α1MG combined detection was 92.9%,which significantly higher than single maker detection(P<0.05).Conclusion The combined detection of serum cystitis C,urinary trans-ferrin and urinary α1 microglobulin have important value in the diagnosis of early diabetic kidney disease.

Objective:To analyze the drug sensitivity of human lung adenocarcinoma stem cells (LASC) to cisplatin (DDP) and carboplatin (CBP). Methods:Human lung adenocarcinomaic cells SPC-A1,AG,and CPA-Y2 were treated with DDP and CBP. The cell viability of cells was detected by CCK-8 assay. The phenotypic characteristics of drug surviving cells(DSCs)were determined by immunofluorescence staining. The LASC population was then separated by magnetic-activated cell sorting method. The LASC in DSCs was traced by using green fluorescence protein (GFP). The drug sensitivity of DSCs to DDP and CBP was analyzed.Results:The LASC exhibited the phenotypes of bronchioalveolar stem cells (BASC, OCT4~+CCSP~+SP-C~+). After mixture of CD221~+LASC with CD221~-lung adenocarcinoma differentiated cells, the DSC population showed OCT4~+BASC phenotypes. These DSCs were significantly resistant to DDP and CBP.Conclusion:LASC has a high resistance to DDP and CBP. This may be the reason for tumor recurrence after chemotherapy.

Objective To explore nursing care of the ex-utero intrapartum treatment (EXIT) in fetal neck mass oppressing airway. Methods A case of EXIT in which a fetal neck mass was diagnosed on ultrasound was fully prepared supplies and carried out. Nursing care was well implemented and vital signs of the puerpera and fetus were observed in preoperative and intraoperative surgery. Results The EXIT procedure was successful performed and vital signs of the puerpera and fetus were steadied. The score of Apgar was seven to eight. Conclusions Adequate equipment, multi-department collaboration, preoperative exercise and close cooperation are the important guarantee for the success of ex-utero intrapartum treatment.

OBJECTIVE[corrected] To investigate the mutation at the transmembrane domain of fibroblast growth factor receptor 3 (FGFR3) nucleotide 1138 site for identifying the major pathologic mechanism of achondroplasia (ACH) and to evaluate the efficacy of denaturing gradient gel electrophoresis(DGGE) method for screening the point mutations.

METHODSThe genomic DNA from 17 clinically diagnosed ACH patients where analysed by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) with Sfc I and Msp I restriction endonucleases and by PCR-DGGE technique for screening.

RESULTSG to A transition mutation at nucleotide 1138 was detected in 14/17 of the ACH patients as heterozygotes by PCR-RFLP with Sfc I digestion. No 1138 G to C transition was detected by Msp I digestion. All of the 14 samples with G to A mutation were also found to be positive for point mutation by PCR-DGGE. No mutation was detected in 3 negative samples by PCR-RFLP, implying that there was actually no point mutation in this amplified region.

CONCLUSIONNucleotide 1138 in transmembrane domain of FGFR3 gene is the hot point for mutation in ACH and hence its major pathologic cause. PCR-DGGE is a sensitive and reliable technique for point mutation screening, especially for the heterozygotes.

Achondroplasia ; genetics ; DNA ; chemistry ; genetics ; DNA Mutational Analysis ; Female ; Humans ; Male ; Point Mutation ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single-Stranded Conformational ; Protein-Tyrosine Kinases ; Receptor, Fibroblast Growth Factor, Type 3 ; Receptors, Fibroblast Growth Factor ; genetics

Objective To observe the characteristics of magnetic resonance angiography of(MRA) ophthalmic artery in patients with diabetic retinopathy (DR).Methods A total of 36 eyes of DR patients (DR group) diagnosed by clinical examination were included in the study.Among them,there were 42 eyes in 21 males and 15 eyes in 15 females.The average age was 55.2 years old.The average duration of diabetes was 7.56 years.All eyes were examined by MRA and fluorescein fundus angiography (FFA) in the ophthalmic artery.At the same time,24 eyes of 12 patients were examined by computed tomography angiography (CTA).Twenty-two healthy volunteers with age and gender matching were selected as the control group.Among them,there were 13 males and 9 females.All patients underwent MRA examination of the ophthalmic artery;at the same time,5 eyes of 5 eyes were examined by CTA.MRA and CTA were classified into three grades according to the development condition and shape change of the ophthalmic artery.0 grade:no abnormality;grade Ⅰ:mild lesion;grade Ⅱ:obvious lesion.According to the results of FFA examination,it was divided into no obvious disease stage,background stage,proliferative stage,proliferative stage.The morphological features of the MRA of the ophthalmic artery in the DR group and the control group were compared.The relationship between the MRA grading of the ophthalmic artery and the FFA staging was observed in the DR group.The consistency analysis between the MRA and CTA grades of the ophthalmic artery in the DR group was performed by Kappa test;the relationship between the MRA grade and the FFA staging of the ophthalmic artery was analyzed by Spearson correlation analysis of the same data with two-way ordered attributes.Results In 44 eyes of the control group,the MRA in grade 0 and Ⅰ of the ophthalmic artery were 41 and 3 eyes,respectively;all eyes of the CTA examination of the ophthalmic artery were grade 0.In 72 eyes of the DR group,the MRA in grade 0,Ⅰ,and Ⅱ of the ophthalmic artery were 28,28,and 16 eyes,respectively.Among the 24 eyes examined by CTA,there were 13,6,and 5 eyes in grade 0,Ⅰ,and Ⅱ,respectively.In the DR group,the classification of MRA and CTA of the ophthalmic artery was highly consistent (Kappa value =0.86).There were significant differences in the number of eyes with different grades of MRA in the DR group and the control group (Z=-5.74,P=0.000).In 72 eyes of the DR group,there were 8,12,22,and 30 eyes in no obvious disease stage,background stage,proliferative stage,and proliferative stage,respectively.Correlation analysis showed that there was a significant correlation between MRA grading and FFA staging in the DR group (r=0.405,P=0.000).Conclusions MRA can show the changes of ophthalmic artery morphology and reflect DR staging to a certain extent.It has a high consistency with FFA vascular changes.

Objective: To explore the efficacy and safety of tertiary hospital guided and community-driven family self-help cardiac rehabilitation model. Methods: This study was a prospective randomized controlled study, 80 patients from Beijing Electrical Power Hospital and Beijing Jingmei Group General Hospital with acute coronary syndrome were included from June to December 2015 and divided into 2 groups. Patients in rehabilitation group (n=52) received tertiary hospital(Peiking University Peoples′ Hospital) guided and community-driven family self-help cardiac rehabilitation for 3 months, and patients in control group (n=28) received routine secondary treatment for 3 months. Following parameters including 6 minutes walk distance, score of life quality (evaluated by Short Form-12), score of anxiety (evaluated by Generalized Anxiety Disorder-7), score of depression (evaluated by Perceived Health Questionnaire-9), self-management competency (evaluated by questionnaire) were collected at baseline and after treatment for 3 months. Results: Compared with control group, 6 minutes walk distance was longer in rehabilitation group((60.2±6.8) meters vs. (24.9±10.5)meters, P<0.01). The difference values between after and before intervention of life quality scores((0.14±3.90)scores vs.(-7.44±5.85)scores, P>0.05), anxiety scores((-0.16±2.12 ) scores vs.(0.70±1.13)scores, P>0.05) and depression scores((-1.17±2.79) scores vs.(0.60±0.36)scores, P>0.05) were similar between the 2 groups. The amplification of patients with regular exercise (50.26% vs. 0, P<0.05), limit sugary foods usually and always (53.22% vs. 3.98%, P<0.05), eat 200-400 g fruits usually and always (78.61 % vs. 0, P<0.05), eat 300-500 g vegetables usually and always (9.74% vs. 0, P<0.05), and answering very confident to questions such as let the physicians know about your diseases (40.17% vs. 5.00%, P<0.05), know how to take medicines (44.52% vs. 5.00%, P<0.05), know how much exercise was right for yourself (26.43% vs.0, P<0.05) were significantly higher in rehabilitation group than in control group. There were no cardiac rehabilitation training related cardiovascular events. Conclusion Tertiary hospital guided and community-driven family self-help cardiac rehabilitation model is an effective and safe management model of cardiovascular disease in chronic phase, and it is necessary to further expand the study population to verify the efficacy of this model.

Objective To compare the efficacy and safety of leflunomide (LEF) combined with medium/low dose corticosteroids and full dose of corticosteroids in the treatment of IgA nephropathy. Method Primary IgAN patients diagnosed by renal biopsy with 18?65 years old and eGFR≥30 ml·min?1·(1.73 m2)?1 and proteinuria>0.5 g/24 h were enrolled in a prospective controlled clinical study. They were randomly divided into leflunomide combined with medium/low dose corticosteroids (LEF group) and corticosteroids alone (steroid group). The primary outcomes were (1) end stage renal disease or dialysis (2) 50% increase in serum creatinine above the baseline. Secondary outcome was the remission of proteinuria. Results Ninety patients completed the follow?up. The 24?hour proteinuria at baseline were 2.00(1.10, 2.88) g and 1.87(1.13 ,3.08) g in LEF group and steroid group respectively. Compared with baseline, it was significantly decreased in both groups at 6 months [0.30(0.11, 0.93) g, 0.30(0.14, 1.33) g] and 12 months [0.30(0.09, 0.82) g, 0.32(0.14, 0.66) g], (P<0.05). Estimated glomerular filtration rate (eGFR) at baseline, 6 months and 12 months were (80.39 ± 28.56), (87.12±28.70) and (88.20±30.26) ml·min-1·(1.73 m2)-1. It was decreased in steroid group (P<0.05), while no significant difference was detected in LEF group[baseline (87.63 ± 27.35), 6 months (86.91 ± 32.45), 12 months (90.06 ± 30.00) ml·min-1·(1.73 m2)-1, P>0.05]. At 6 and 12 months, there was no significant difference in terms of 24?hour proteinuria, serum creatinine and eGFR (CKD?EPI) between groups (P>0.05). There was no statistically significant difference in adverse events between groups during the treatment (9/40 cases in LEF group and 11/50 cases in steroid group, P>0.05). The average follow?up was 79 months, and there was no difference in the renal prognosis between the two groups. Multivariate Cox regression analysis revealed that serum creatinine at baseline and renal interstitial inflammatory cell infiltration predicted the risk of the progress of IgA nephropathy. Conclusion Leflunomide plus medium/low dose corticosteroids has a similar effect as full dose of corticosteroids in IgA nephropathy and does not increase the risk for adverse events during the treatment.