To elucidate the effect and effective mechanism of gonadotropin-releasing hormone analog (GnRHa) on growth axis and gonadal axis in puberty rats.

Objective To evaluate surgical management of pancreatic duct stones.Methods From 1997 to 2007, 24 cases of pancreatic duct stones underwent surgical treatment, the clinical data were retrospectively analyzed. Results In this study, 17 cases underwent lithotomy by longitudinal pancreatic duct incision, Roux-en-Y anastomosis(side-to-side) of pancreatic duct to jejunum, extra drainageof the main pancreatic duct was done in two cases, hepaticojejunostomy in three cases, pancreaticcystojejunostomy in one case. One case suffered from postoperative bleeding at pancreatic ojejunostomy, one from stress ulcer, and both were cured by conservative treatment. Three cases underwent pancreaticeduodenectomy, anastomosis bleeding occurred in one patient, and was cured by conservative method. One case underwent duodenum-preserving resection of the head of the pancreas, 2 cases underwent distal pancreatectomy, one case underwent lithotomy by pancreatic duct incision and primary closure, no postoperative complications occurred among those patients. 21 cases were followed up, results were excellentin 17 patients. Conclusions Lithotomy by longitudinal pancreatic duct incision, Roux-en-Y anastomosisof pancreatic duct to jejunum is the main and effective surgical procedure, while duodenum preserving pancreatic head resection and lithotomy by pancreatic duct incision and primary closure are also rational for the treatment of pancreatic duct stones.

NS2 is a nonstructural protein of Periplaneta fuliginosa densovirus(PfDNV) with a molecular mass of 30 kD,whose function is not yet clearly understood. In order to study the expression,subcellular distribution and the function of NS2 protein,the coding region of NS2 was amplified from the hindgut tissue of cockroaches infected with PfDNV by RT-PCR and then the recombinant prokaryotic expression vector pET28a-NS2 was constructed. The recombinant plasmid was transformed into E. coli BL21(DE3) to express the 6?His fusion protein in the bacteria. After purification,the fusion protein was injected into New Zealand rabbits to prepare polyclonal antibody. The specificity of the anti-NS2 antibody was successfullyproved by western blotting on the eukaryotic expressed products of NS2 protein.Meanwhile,the full sequence of ns2 gene was also cloned into the eukaryotic expression vector pAC. The recombinant plasmid pAC-NS2 was then transfected into Schneider line 2(S2) cells to express NS2 protein in the insect cells. The subcellular localization of NS2 in the insect cells was then investigated by indirect immunofluorescence technique using the anti-NS2 polyclonal antiserum. The confocal laser scanning microscope observation showed that NS2 protein was located primarily in the cytoplasm with some punctate nuclear staining.

Objective To observe the incidence and awareness of dyslipidemia in newly diagnosed elderly type 2 diabetic patients,and to determine the efficacy and safety of simvastatin and Xuezhikang in the treatment of dyslipidemia.Methods Totally 255 newly diagnosed type 2 diabetic patients aged 60 to 75 years in CDCPS research were included and the incidence of dyslipidemia were retrospectively analyzed.Patients were divided into 3 groups:the group 1 was given simvastatin (20 mg/d); the group 2 was given Xuezhikang (0.6～ 1.2 g/d); the group 3 was given no lipid-lowering drugs.All the three groups were given lifestyle intervention and blood pressure and blood sugar control.All patients were followed up monthly and TG,TC,LDL-C,BUN,ALT and creatinine were examined at 7th,14th,and 20th months.Results The incidence of dyslipidemia and the rate of awareness in the study cohort was 62％ and 55.7％.Hypertriglyceridemia was the most common type of dyslipidemia (29％).Among 88 patients with dyslipidemia,25 (28.4％) patients had been treated with lipid-lowering drugs before our study,in whom,8(32％) patients had normal serum lipid levels and only 3 (12％)patients reached to the control standards.20 months after the treatment,the decrement scales of TG,TC and LDL-C were 1.8％,10.5 ％ and 20 ％ respectively in group 1;5.5 ％,15.0％ and 15.7％ respectively in group 2;2.7％,8.7％ and 4.5％ respectively in group 3.The long-term lifestyle intervention and blood pressure and blood sugar control reduced serum lipid to some degree.In the patients with dyslipidemia,lipid-lowering drugs had a better effect on serum lipid reduction than did the lifestyle intervention (P=0.0047,0.0433).There was no significant difference between simvastatin and Xuezhikang.The function changes of liver and kidney had no difference before and after drug intervention (P＞0.05).Conclusions Serum lipid should be monitored and early medicine intervention should be taken in newly diagnosed elderly type 2 diabetic patients.Medicine intervention has a better effect on serum lipid reduction than lifestyle intervention,and there are no significant differences in efficacy and safety between simvastatin and Xuezhikang.

Objective To analyze the initial treatment strategies, blood glucose control and reaching standard status of newly diagnosed type 2 diabetes mellitus (T2DM) in the middle-aged and elderly. Methods The 771 patients diagnosed with T2DM newly or within one year, aged 50-70 years, selected from Chinese Diabetes Complication Prevention Study (CDCPS) were enrolled in this study. The correlations of initial treatment strategies with blood glucose control (target value of glycated hemoglobin was less than 7.0%) and reaching standard status were analyzed retrospectively. Based on the same lifestyle intervention, the therapy was further divided into group A (without medication), group B (single oral hypoglycemic agent), group C (combined oral hypoglycemic agents), group D (treatment including insulin). Results Although receiving the different treatments, the 771 patients had a similar mean glycated hemoglobin level, from 7.2% to 7.7%, among the four kinds of intervention before entering the study. The increased intensity and complexity after therapy adjustment along with the increased glycated hemoglobin level was observed at baseline. The corresponding relationships between medication and HbA1c were as follow: without medication-6.1%, single oral hypoglycemic agent-7.2%, combined oral hypoglycemic agents-7.7%, treatment including insulin-9.2%. After 20 months of follow-up, the mean fasting glucose and glycated hemoglobin were 6.6 mmol/L and 6.2%, separately. According to the target glycated hemoglobin level of less than 7.0%, all four-kinds of therapies had high achievement rates, which were all above 80% except that was 63.2% in group D. Sulphonylurea and biguanide as initial single oral hypoglycemic agent therapy had the similar effectiveness on glucose control and target glycated hemoglobin achievement. Conclusions According to the levels of glucose and glycated hemoglobin, multiple individual therapies should be enacted at the beginning of treatment. The strategy mainly based on sulphanylurea and biguanide is proved to be persistently effective in newly-diagnosed middle-aged and elderly diabetic patients in China.

Objective To confirm the optimal tissue sampling location of current injury combined with the histopathological observation in specific parts of electrocution based on previous animal experiments. Methods Twenty-three human cases from the autopsy through the hand-to-foot circuit pathway were analyzed. Additional ten autopsy patients who died from traffic accidents and sudden cardiac attacks were used as the control group. All cases were extracted the soft tissues from the upper anterior wrist and medial malleolus to further observe and analysis the L/S axis ratio of the nuclei of the skeletal muscle cells (SkMCs) and artery smooth muscle cells (ASMCs). Results The age of the 23 eligible electrical deaths ranged from 19 to 59 years, including 19 cases were male and 4 cases were female. 3 cases were high-voltage 20 cases were low voltage. The occurrence rate of electric marks averaged 31.18% in all cases. The incidence of the classical arborizing pattern of fine branching was 36.4%, appearing on the pleura in 5 cases (22.7%). The nuclei of the SkMCs and ASMCs nuclei in the anterior wrist and medial malleolus within the electrical current pathway were obviously stretched, narrowed, and coalesced, presenting a nuclear polarization and arranging as line-like and moniliform patterns. The L/S axis ratio of those nuclei in the anterior wrist and medial malleolus were markedly increased as compared with the control group (p < 0.001). Through the ROC curve analysis, the critical diagnostic values of the L/S axis ratio of those nuclei were respectively 4.84 and 3.81. Conclusion These findings suggest that the soft tissues of the anterior wrist and/or the medial malleolus, as the narrowest parts of the limbs, could be used as the sites for tissue sampling and considered as necessary locations for histopathological examinations to determine the electrocution in medicolegal identification.

OBJECTIVETo describe trends of changes in blood lead levels in children aged 1 - 6 years during the time period before and after introducing lead free gasoline in Shanghai 1997 and 1999.

METHODSBlood lead levels of 1 969 children aged 1 - 6 years were determined by a sampling survey in five districts of Shanghai in August and September, 1997. Blood lead levels of the same population were re-determined by the same method from April to June in 1998 and from August to September in 1999. Filter paper blood lead test was carried out monthly using the filter paper blood lead proficiency testing program of Centers for Disease Control in the United States. The results from blood lead samples were under acceptable ranges during the study.

RESULTSThe geometric means of blood lead levels were 83 microgram/L in 1997, 80 microgram/L in 1998 and 76 microgram/L in 1999, respectively. The prevalence rates of childhood lead poisoning (blood lead level was equal or more than 100 microgram/L) were 37.8% in 1997, 25.7% in 1998 and 24.8% in 1999. The amounts of decrease on average blood lead levels in the five districts between 1997 and 1999 were 10 microgram/L, 11 microgram/L, 6 microgram/L, 4 microgram/L and 2 microgram/L, respectively.

CONCLUSIONLead poisoning is a preventable disease. The average levels of lead in young children in Shanghai decreased significantly after the introduction of lead free gasoline to Shanghai. Lead emissions from vehicles running on leaded gasoline was one of the important contributors to increase the children's blood lead levels in Shanghai. Lead poisoning is not evenly distributed among children in Shanghai, resulting in the different levels of decline.

Child, Preschool ; China ; Environmental Monitoring ; methods ; standards ; Environmental Pollutants ; blood ; Gasoline ; standards ; Humans ; Lead ; blood ; Time Factors

Objective To analyze the impact of atorvastatin on blood lipids and arterial media thickness(IMT)in new-onset type 2 diabetes patients. Methods 333 patients,30-70 years old and diagnosed within one year as type 2 diabetes,were selected from the Chinese Diabetes Complication Prevention Study(CDCPS)to take part in this study. Changes of blood lipids and IMT of carotid, femoral and iliac artery pre and post the administration of atorvastatin were tested and followed for 24 months. Results Total cholesterol,triglycerides and low-density lipoprotein decreased significantly (P=0.000)and maintained at a low level. The carotid artery IMT decreased significantly(P=0.022) at the end of this study,but the femoral and iliac artery IMT did not show any obvious change. There were no serious adverse events noticed,during the study period. Conclusion Long-term use of atorvastatin seemed to be safe and effective in reducing blood lipids in patients with type 2 diabetes thus could delay the development of atherosclerosis.

Objective:To investigate the safety and efficacy of ultrasound-guided sclerotherapy combined with radiofrequency ablation on the complex lymphatic malformations (LM) in children.Methods:The clinical data of 21 children with complex LM treated with ultrasound-guided sclerotherapy combined with radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from June 2018 to October 2021 were retrospectively analyzed.Intraoperative and postoperative complications were recorded.Imaging examinations were performed at 1, 3, 6, 9, 12, 18, 24 months postoperatively to observe the recurrence, the volume of the lesions and their reduction rate were calculated, and the efficacy was analyzed. Friedman test was used to compare the lesion volume at different time points before and after surgery, and the reduction rate of lesion volume at 1 month postoperatively and other time points after surgery. Results:A total of 21 children were included in this study, among them, there were 12 males and 9 females, age range from 1 month to 5 years and 6 months, with a median age of 23 months.A total of 26 LM in 21 children were successfully treated, and no serious complications like organ damage occurred during and after surgery.One patient with abdominal LM had a postoperative infection, which was controlled by 3 weeks of catheter drainage.Four LM in 3 children recurred at 3 or 6 months after surgery, while all lesions were significantly narrowed down than those before surgery and they were cured after 1-3 sessions of continued sclerotherapy.There were significant differences in the lesion volumes before surgery and 1, 3, 6, 9, 12, 18 and 24 months postoperatively [222.26(159.57, 316.40) cm 3vs.43.06(22.74, 62.53) cm 3, 31.56(15.49, 45.94) cm 3, 25.21(9.63, 36.22) cm 3, 19.80(6.79, 28.81) cm 3, 12.80(3.93, 20.38) cm 3, 7.13(0, 11.34) cm 3, and 2.79(0, 4.93) cm 3; all P<0.05]. There were significant differences between the volume reduction rates at 1 month postoperatively and 3, 6, 9, 12, 18, and 24 months postoperatively [79.36(73.30, 87.81)% vs.85.40(81.09, 91.61)%, 88.85(84.70, 93.61)%, 91.67(87.87, 95.05)%, 94.15(94.47, 97.35)%, 97.11(95.02, 100.00)%, and 99.04(97.93, 100.00)%; all P<0.05]. Patients were followed up for 24 months, and all of them were cured. Conclusions:Ultrasound-guided sclerotherapy combined with radiofrequency ablation is a minimally invasive, safe and effective therapeutic strategy for children with complex LM.

Given the systematic, rigorous, and practical characteristics of medical disciplines, ensuring the teaching quality of online courses has become a significant focus. In traditional teaching models, teaching supervision is an important method to guarantee instructional quality, and introducing teaching supervision into online teaching activities is of great significance. This article systematically reviews and summarizes the domestic and international experience of conducting online medical courses. We explore the instructional supervision of online medical courses from the following perspectives: the meaning of supervision, the necessity of online supervision, online supervision methods and technical approaches, the feedback and application of supervision information, and the establishment of a standardized online supervision process.