High-fat diet-induced insulin resistance rat model was assessed by euglycemic-hyperinsulinemic clamp technique.Compared with the control group,the vaspin mRNA expression in adipose tissue was significantly decreased in insulin resistant rats induced by high-fat diet( P＜0.05 ),which was increased by metformin( P＜0.05 ).These data indicate that metformin may ameliorate insulin resistance in rats via upregulating vaspin mRNA expression.

BACKGROUND: The comparative study concerning the safety of umbilical cord and bone marrow-derived mesenchymal stem cells transplantation for the treatment of nervous system lesions is insufficient. OBJECTIVE: To assess the safety of umbilical cord and bone marrow-derived mesenchymal stem cells transplantation for treatment of nervous system lesions. METHODS: A total of 214 cases with neuropathy were randomly divided into A, B groups. Patients in the A group received umbilical cord derived stem cell transplantation, and those in the B group received bone marrow-derived mesenchymal stem cells transplantation. Totally (5-12)×108 stem cells were transplanted into each patient. RESULTS AND CONCLUSION: The count of lymphocytes, alanine aminotransferase, aspartate aminotransferase, IgA, and IgM were increased compared with those before treatment in both groups (P < 0.01); However there were no significant differences between two groups (P > 0.05). Moreover, white blood cell count and red blood cell count in cerebrospinal fluid of all patients were significantly greater than the normal level. There were no significant differences between two groups (P > 0.05). No significant differences of the positive rate of Pandy test and the incidence rate of adverse effect were found in both groups (P > 0.05). The safety of umbilical cord and bone marrow-derived mesenchymal stem cell transplantation for treatment of nervous system lesions showed no marked differences.

After 4 weeks old male Sprague-Dawley rats were fed with normal diet and high-fat diet for 10 weeks,the rats were treated with metformin (200 mg/kg) for 6 weeks. Insulin sensitivity was determined by hyperinsulinemic-euglycemic clamp technique.Realtime PCR and western blot were used to measure mRNA and protein levels of chemerin in perirenal adipose tissue of rats.The results showed that the expressions of chemerin mRNA and protein were higher in high-fat diet-induced insulin resistant rats compared with rats fed with normal diet ( both P＜0.05 ),and these incremental findings were diminished by metformin treatment ( both P＜0.01 ).The levels of chemerin mRNA and protein were correlated well with the epididymis fat mass index.

Objective To analyze the clinical value of chemotherapy combined with endocine therapy after standard treatment failure for advanced metastatic breast cancer.Methods 30 metastatic breast cancer patients after standard treatment failure were analyzed.Etoposide (75-100 mg/d) wasused on days 1-10,followed by 11 days of rest combined with medroxyprogesterone 0.5 g,twice per day,or megestrol 160 mg/d for 21 days.Clinical effects and life quility were analysed.Results The median treatment line of this therapy was 6 (range 3-9).The clinical benefit rate is 16.7 ％ (5/30),and the median progression free survival (PFS) was 4.0 months (range 1.0-13.0 months).Conclusion The combination of chemotherapy (etoposide) and endocrine therapy (progesterone) is a choice of treatment after standard drug failure for advanced mastatic breast cancer patients.

Abstract: Objective To compare the diagnostic efficacy of the upgraded version of the GeneXpert automated fluorescent quantitative PCR system (GeneXpert MTB/RIF Ultra, GeneXpert Ultra) and the original version of the GeneXpert system (GeneXpert MTB/RIF, Xpert), real-time fluorescent quantitative nucleic acid detection (FQ-PCR), real-time fluorescent thermostatic amplification of Mycobacterium tuberculosis RNA (SAT-RNA), real-time fluorescent thermostatic amplification detection of DNA (thermostatic amplification method) and traditional BACTEC MGIT 960 liquid culture (culture method) for special specimens of tuberculosis, in order to analyze its application value in clinical detection. Methods Using prospective research methods, a total of 170 special specimens (including 47 pleural and ascites effusion samples, and 34 24-hour urinary sediment specimens, 49 tissue specimens and 40 fester specimens) were collected i'an Chest Hospital from January to September 2021. GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were used for detection. Clinical diagnosis was used as the standard, and sensitivity, specificity, positive predictive value, negative predictive value, coincidence rate, and Kappa value were compared among the methods. Results The sensitivities of GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were 65.18% (73/112), 49.11% (55/112), 37.50% (42/112), 19.64% (22/112), 8.04% (9/112), and 22.32% (25/112), respectively. The sensitivity of GeneXpert Ultra was higher than that of the other five methods, and the differences were statistically significant (χ2=66.25, 42.10, 28.89, 13.09, 4.92, 15.18, all P<0.05). GeneXpert Ultra result analysis showed that: 5.48%(4/73) cases had trace, that is, trace Mycobacterium tuberculosis load, 79.45% (58/73) cases were extremely low, 10.96% (8/73) cases were low, 2.74% (2/73) were medium, , and 1.36% (1/73) were high load. In 4 trace samples, the Xpert detection was negative for all. Of the 73 GeneXpert Ultra positive reports, 63 were rifampicin-sensitive, 6 were rifampicin-resistant, and 4 were rifampicin-resistant but of unclear resistance. Of the 55 Xpert positive reports, 45 were rifampicin-sensitive, 2 were rifampicin-resistant, and 8 were rifampicinresistant but of unclear resistance.. Conclusions The new generation of GeneXpert MTB/RIF Ultra has high sensitivity, specificity and drug resistance detection rate, and its advantage is even more apparent in the pathogenic diagnosis of special specimens of tuberculosis. It can be used as one of the preferred methods in samples with low bacterial load.

Objective:To determine the clinical efficacy of posterior intervertebral surgery for single-segment thoracolumbar spinal tuberculosis.Methods:Clinical data were retrospectively analyzed in 62 patients with thoracolumbar spinal tuberculosis who underwent posterior intervertebral surgery (A group) or posterior and anterior combined intervertebral surgery (B group) from January 2010 to January 2015 in Department of Spinal Surgery,General Hospital,Ningxia Medical University.The operative time,blood loss,length of hospital stay,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) level,neurological function,VAS score,vertebral Cobb angle,bone healing,and postoperative complications were compared between the 2 groups.Results:All patients were followed up for 10 to 30 (average 22) months after the operation.In the A group,operative time,blood loss,and hospital stay were less than those in the B group (P＜0.05).In the follow-up,the pain of patients was alleviated and nervous function was improved obviously in the 2 groups compared with pre-operation.The ESR and CRP at the 6 months after operation returned to the normal range in patients of the 2 groups.There were significant differences in the ESR and CRP among the pre-operation,the 6 months after operation,and the end of follow-up within the group (P＜0.05),while there were no significant differences in ESR and CRP between the 6 months after operation and the end of follow-up (P＞0.05).There were no significant differences in the ESR and CRP among the pre-operation,the 6 months after operation,and the end of follow-up in the 2 group (P＞0.05).The Cobb angles after the operation and the end of follow-up were significanthy smaller than those before the operation (P＜0.01),while there were no significant differences in Cobb angle before operation,after the operation,and the end of follow-up between the 2 groups (P＞0.05).There were no significant differences in the bone healing rate at 6 months or 1 year after operation between the A group and B group (P＞0.05) and the complication rate of the A group was lower than the B group (P＜0.01).Conclusion:Clinical efficacy of posterior intervertebral surgery is satisfatory in treating single-segment thoracolumbar spinal tuberculosis with less complications.

Objective:To investigate the difference between simple posterior interbody fixation and fusion and posterior interbody fixation combined with focus debridement and bone graft fusion for the treatment of mono- and bi-segmental lumbar brucella spondylitis.Methods:A total of 63 patients (42 males and 21 females), aged 50.9±8.18 years (range from 38 to 69 years) with mono- and bi-segmental lumbar brucella spondylitis who received surgical treatment from June 2014 to Feb 2018 were retrospectively analyzed. There were 44 cases of mono-segmental and 19 cases of bi-segmental. Thirty-one cases were treated with single posterior interbody fixation and fusion (PIFF group), and 32 caseswere treated with posterior interbody fixation combined with focus debridement and bone graft fusion (debridement group). The main observation indicators include operation time, intraoperative blood loss, postoperative hospital stay, postoperative medication time, Visual Analogue Scale(VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Frankel score and clinical efficacy.Results:All of 63 patients were followed up for 27.16±6.07 months (range 15 to 38 months). The operation time of mono-segmental patients of PIFF group was 105.86±16.66 min,the intraoperative blood loss was 295.00±55.11 ml, and the postoperative hospitalization was 4.45±1.53 days, which was significantly shorter than debridement group ( P<0.001), while the postoperative medication time was without significant difference between the two groups ( P>0.05). The opration time of bi-segmental patients of PIFF group was 150.33±26.29 min, the intraoperative blood loss was 242.05±50.56 ml, and the postoperative hospitalization was 4.56±1.50 days, which was significantly shorter than debridement group ( P<0.001), while the postoperative medication time was also without significant difference between the two groups. At the last follow-up time, the VAS scores and ODI values of mono- and bi-segments in PIFF group and debridement group were lower than those preoperation, but there was no significant difference between the two groups ( P>0.05). There was no significant difference in CRP between mono-segments of PIFF group and debridement group at the preoperation, 3 months after operation and the last follow-up time ( P>0.05). The CRP in mono-segments of PIFF group and debridement group decreased at 3 months after the operation compared with that preoperation, and the difference was statistically significant ( P<0.001). There was no significant difference in CRP between bi-segments of PIFF group and debridement group at 3 months after operation and the last follow-up time ( P>0.05). There was no significant difference in ESR between mono- and bi-segments of PIFF group and debridement group at 3 months after operation and the last follow-up time ( P>0.05). There was significant difference in ESR between mono- and bi-segments of PIFF group and debridement group at the preoperation, 3 months after operation and the last follow-up time. There was no statistical difference in the proportion of excellent postoperative clinical efficacy between the two groups. Complications were observed in two patients in PIFF group (6.5%, 2/31) compared with 8 patients in debridement group (25%, 8/32, χ2=4.057, P=0.044). Conclusion:On the basis of standardized anti-brucella drug therapy, simple posterior interbody fixation and fusion for the treatment of brucella spondylitis has a satisfactory surgical effect, and has the advantages of less surgical trauma, shorter time, earlier postoperative movement time and fewer complications.

Objective To investigate the distribution characteristics of serum sIgE antibodies against four allergenic protein components of egg white in children with egg allergy,and then clarify the clinical application value of single component-resolved diagnostics of egg allergy.Methods Serum samples from 197 children with egg allergy were collected.The levels of serum sIgE antibodies against four major allergenic protein components of egg white,including ovomucin,ovalbumin,ovotransferrin,and lysozyme,were detected by the light-excited chemiluminescence assay(LiCA),and the distribution characteristics of sIgE antibodies were analyzed.Results The positive rates of serum sIgE antibodies against ovalbumin,ovomucin,ovotransferrin,and lysozyme in 197 chlidren with egg allergy were 77.16%(152/197),70.56%(139/197),35.02%(69/197),and 18.27%(36/197),respectively.The positive rate of serum sIgE antibody against both ovomucin and ovalbumin was 30.45%.There was a weak correlation between the levels of sIgE antibodies against egg and the cumulative levels of sIgE antibodies against four allergenic protein components(r=0.266 8,P＜0.05).There were signifi-cant individual differences in the levels of serum sIgE antibodies against four allergenic protein components of egg white in the children with egg allergy.Conclusion There is individual heterogeneity in the levels of serum sIgE antibodies against four components of egg white in the children with egg allergy.The detection of sIgE antibodies against egg white components can distinguish different forms of egg allergies,which is of great value for the accurate diagnosis and precise desensitization of children's egg allergy.

Objective To explore the effect of posterior debridement, grafting and internal fixation for treatment of non-specific lumbar intervertebral infection. Methods Clinical data of 20 patients with non-specific lumbar intervertebral infection treated in General Hospital of Ningxia Medical University from October 2013 to June 2013 were retrospectively analyzed. There were 15 males and 5 females with an average age of 41 years (range, 36-51 years). All patients suffered from single lumbar inter-vertebral infection, including 3 cases at L2/3,4 at L3/4,10 at L4/5 and 3 at L5/S1. All 20 cases underwent one-stage posterior debride-ment, autogenous bone grafting and internal fixation, tissue samples in focus were collected for bacterial culture and pathological examination. The disease controlling statues were evaluated based on laboratory results of ESR and CRP. Imaging examinations were taken to evaluate the fusion of vertebral body. Clinical effects were evaluated using the visual analog scale (VAS) and the Jap-anese Orthopaedic Association scores (JOA) score of lumbar fumction. Results All patients underwent the surgery successfully. The surgery duration time was 90-160 min, average 125 min, and the blood loss was 200-700 ml, average 360 ml. Cerebrospinal fluid leakage occurred in one case. Postoperatively, all patients experienced significant reliefof back pain, improving in the func-tion of movement, and no fever. The lower back VAS score: average (5.35 ± 1.15) points before operation , average (2.76 ± 0.34) points one week after operation, and an average score of (0.85±0.65) points by the last follow-up time. JOA lumbar function score:all patients were effective after operation, the improvement rate was excellent in 65%(13cases), good in 25%(5 cases), and pass-able in 10%(2cases). Comparing with preoperation, the excellent and good rate was 90%. All patients ESR and CRP returned to normal levels at the last follow-up. Ordinary bacterial culture was positive in 8 cases and negative in 12 cases. The pathogens iden-tified were staphylococcus aureus (6 cases), Escherichia coli (2 cases) and staphylococcus epidermidis (2cases). All incisions achieved primary healing. All patients were followed up from 6-18 months (average,12 months), and the symptom of pain relieved significantly. No recurrent infection had happened. A solid bony fusion was found in all patients at 6-14 months (average, 8.5 months) after the surgery. Conclusion Posterior debridement, grafting and internal fixation are effective treatments for non-spe-cific lumbar intervertebral infection, can reduce the time of staying in hospital, this operation is safe and reliable.

Objective To discuss the clinical efficacy of surgical treatment of pathologic vertebral surgery for thoracic and lumbar tuberculosis. Methods All of 322 cases of thoracic and lumbar spinal tuberculosis patients from December 2003 to June 2014 were retrospectively analyzed in our department. All patients were underwent debridement, fusion and nerve decompres?sion surgery. According to different fixed methods, patients were divided into pathologic vertebral surgery group (fixation complet?ed within lesions invaded motion unit) including 91 males and 100 females, with an average age of 41.53 years, and non?pathologic vertebral surgery group (long segments or short segment fixation) including 61 males and 70 females, with an average age of 42.72 years. We observed the tuberculosis cure rate, degrees of deformity, pain and neurological recovery, operative time, blood loss and complications by follow?up. Results The average follow?up time was 75.52 months in pathologic vertebral surgery group and 76.21 months in non?pathologic vertebral surgery group. The total number of pathologic vertebras in pathologic vertebral surgery group and non?pathologic vertebral surgery group were 277 and 218 respectively, and the average was 1.45 and 1.66. The total number of fixed segments was 277 in pathologic vertebral surgery group and 485 in non?pathologic vertebral surgery group, and the average fixed segments was 1.45 and 3.70. The cure rate was 85.86%in pathologic vertebral surgery group and 85.49%in non?pathologic vertebral surgery group at 6 months postoperatively, and 98.95%and 98.47%at the last follow?up time, with no signifi?cant difference between groups. Graft fusion rate was 89.00%in pathologic vertebral surgery group and 89.31%in non?pathologic vertebral surgery group 6 months postoperatively, 98.38%and 98.47%at the last follow?up time, without significant difference. In lumbar spine, the average correction of Cobb's angle was 12.4° in pathologic vertebral surgery group and 13.1° in non?pathologic vertebral surgery group, and the average angle loss was 1.3 and 1.4°, with no significant difference. In thoracolumbar, the average correction of Cobb’s angle was 10.9°in pathologic vertebral surgery group and 11.1°in non?pathologic vertebral surgery group, and the average angle loss was 1.7°and 1.5° respectively, without significant difference. However, in thoracic, the average correction of Cobb's angle was 10.2° in pathologic vertebral surgery group and 12.7° in non?pathologic vertebral surgery group, and the average angle loss was 3.6° and 2.5°respectively, with significant difference. The mean operation time was 210.45 min in pathologic verte?bral surgery group and 210.45 min in non?pathologic vertebral surgery group, with significant difference. The average blood loss was 726.12 ml in pathologic vertebral surgery group and 726.12 ml in non?pathologic vertebral surgery group, with significant dif?ference. The complication rate was 11.51%in pathologic vertebral surgery group and 11.45%in non?pathologic vertebral surgery group, with no significant difference. Conclusion Pathologic vertebral surgery surgery is a safe, effective and feasible method of operation for treatment of thoracic and lumbar tuberculosis, which can effectively preserve adjacent normal vertebral motion unit features. The thoracic surgery was less satisfactory than the lumbar and thoracolumbar surgery.