Objective To investigate the effects of metformin on serum visfatin and the level of visfatin mRNA in visceral adipose tissue of type 2 diabetic rats.Methods Forty Wistar rats were randomly assigned into normal diet group (NC) and diabetic group.The rats in the diabetic group were fed with high glucose and high fat diet, and then injected with streptozotocin (STZ).The diabetic rats were divided into diabetic control (DC), metformin (MET), and insulin-treatment (INS) groups.Eight weeks later, body weight (BW) , visceral adipose tissue weight, and biochemical indicators were assessed.Homeostasis model assessment of insulin resistance (HOMA-IR) and Lee index were calculated.The serum visfatin levels were detected by enzyme-linked immunoassay (EIA), and the visfatin mRNA levels of visceral adipose tissues were detected by real time polymerase chain reaction (PCR).Results Compared to group DC, the visfatin levels of serum and visceral adipose tissue mRNA were lower in INS group, but did not have significant difference (P ＞ 0.05);the visfatin levels of serum and visceral adipose tissue mRNA in MET group were significantly lower (P ＜ 0.01).Conclusions Metformin can reduce the visfatin levels of serum and visceral adipose tissue mRNA, and improve the insulin resistance in type 2 diabetic rats.

Objective To investigate the dosimetric properties of PTW 60019 synthetic diamond detector in small photon beams.Methods A PTW 60019 synthetic diamond detector was tested under 6 and 10 MV photon beams,respectively.Linearity with dose,dose rate dependence and off-axis ratio were measured and compared to those measured by an IBA SFD.Percentage depth doses were measured and compared to those measured by an IBA SFD and a PTW 31010 semiflex chamber.Total scatter factors were measured and compared to those measured by an IBA SFD and a PTW 31016 PinPoint chamber.Results The dose response of a PTW 60019 synthetic diamond detector showed a good linear behavior as a function of dose,with observed deviations below 0.2％ over a dose range from 100 to 1 000 MU.The dose rate response was almost independent,with deviations below 0.2％ in the dose rate range from 37 to 614 MU/min.For the fields of 20-100 mm in diameter,there were dose differences in percentage depth doses within 1％ as compared to an IBA SFD and a PTW 31010 semiflex chamber.For the 10 mm diameter field,the differences were up to 5.8％ in the build-up region.Off-axis ratios measurements showed a good agreement among the involved detectors (＜ 1％).The higher differences appeared in the penumbra region.A good agreement was also found in terms of total scatter factor measurements for the related detectors.Conclusions The observed dosimetric properties of the PTW 60019 synthetic diamond detector indicate that it is a suitable candidate for small photon beam dosimetry.

Objective To evaluate the hemocompatibility of polydioxanone(PDO)bioabsorbable stents.Methods Whole blood clotting time,prothrombin time(PT),activated partial thromboplastin time(APTT),platelet adhesion and hemolysis were used to evaluate the hemocompatibility of PDO bioabsorbable stents,and the results were compared with those of 316L stainless stents which are widely used clinically.Results The anticoagulant property of PDO bioabsorbable stents was similar to that of 316L stainless stents.Both PDO bioabsorbable and 316L stainless stents were not prone to activate blood coagulation factors.Compared with 316L stainless stents,PDO bioabsorbable stents had weaker platelet adhesion and activation.Hemolysis ratios of two groups were less than 5%.Conclusions PDO bioabsorbable stents had good hemocompatibility in vitro.

Objective To evaluate the value of serum galactomannan (GM) detection for invasive pulmonary aspergillosis (IPA) diagnosis. Methods The suspicious IPA patients were divided into proven,clinical and possible IPA groups. The patients excluded of IPA were recruited as controls. The serum GM concentration was detected by Platelia Aspergillus double?sandwich enzyme linked immunosorbent assay(ELISA). Re?sults In the 103 patients,there were seven cases diagnosed as proven,nineteen cases diagnosed as clinical and forty cases diagnosed as possible IPA patients. Setting 0.5 as the optimal result for GM detection,the sensitivity,specificity,positive predictive values and negative predictive values of GM were 85.7%,86.5%,55%and 97%,respectively. In non?neutropenia patients combinded with the pulmonary chronic diseases,the sensitivity, specificity,positive predictive values and negative predictive values of GM detection were 71.4%,84.4%,66.75%and 87.1%,respectively. Conclu?sion Index>0.5 for GM test could increase the sensitivity without obvious decreased specificity. GM detection could provide valuable information in patients of non?neutropenia underlying the pulmonary chronic diseases,which had a better sensitivity and specificity versus conventional diagnostic tests.

OBJECTIVE To analyze the resistance of Enterobacter cloacae AmpC ?-lactamase with/without being induced by imipenem(IMP),cefepime(FEP),ceftriaxone(CRO) and aztreonam(ATM).The ampD genes of mutant strains were sequenced. METHODS Five wild type strains and 5 hyper-inducible type strains of E.cloacae were selected and induced by the tested antibiotics in vitro.At the same time,antibiotic susceptibility tests,3-D test,isoelectric focusing(IEF) and inhibit experiment were detected to identify hyper-producing AmpC ?-lactamase.ampD Gene sequencing was preformed in part of mutant strains. RESULTS There wasn′t obvious alteration in MIC with IMP,FEP,CRO and ATM for wild type strains whether they were induced or not.But,for the hyper-inducible type,there was apparent increasing in MIC after antibiotics inducing,especially CRO and ATM,up to 10.7-128 times.The DNA sequences analysis in the mutation strains showed there existed the replacement of the single base in multiple sites,and a few sites of amino acid were altered. CONCLUSIONS Mutant sites in ampD gene sequences are identical even though antibiotics as inducer are different.

Objective To summarize the clinical features,neuroimaging findings and pathological characteristics of demyelinating pseudotumors(DPT)of the brain,and to differentiate it from glioma. Methods The clinical features,neuroimaging findings and pathological characteristics of 35 patients with demyelinating pseudotumors of the brain were summarized,and the diagnosis for 18 of them was confirmed by bioscopy.Results Demyelinating pseudotumors affected adults of both sexes.The onset age of patients ranged from 9 to 69 years old.There was no definite antecedent,and the clinical syndromes were atypical. Neuroimaging scans showed multiple lesions in cerebral hemisphere,while the lesion in brain stem and spinal cord was single.The symptom and neuroimaging were not parallel.While with many or large lesions, the symptoms and signs were less.The lesions were not enhanced on CT scan,but appeared round or patch enhancement on MRI scan.Nine patients with DWI all appeared high density.The myelin basic protein was useful for diagnosis.The typical pathological changes were demyelination,perivascular inflammatory infiltration and reactive gliosis.The Creutzfeuldt cells were also found in these patients.The lesions might become small or disappear after treatment,but could not serve as the criterion to exclude brain neoplasm. Conclusions DPT is a distinct demyelination disease entity,which is confusable with brain neoplasm.It is difficult to distinguish DPT from brain neoplasm with the clinical features and conventional neuroimaging scan.But DWI scan is useful.The pathological changes accord with demyelination,and Creutzfeuldt cells are also found.It is important to apply corticosteroid treatment or biopsy rather than being anxious to excise the lesions.

10.3969/j.issn.2095-4344.2013.25.017

BACKGROUND:Previous experiments have prepared shape memory polymer based on D,L-poly(lactic acid). According to domestic technical requirements for biological y evaluating biomaterials and medical equipments, tissue-engineered grafts must be subjected to preclinical experiment for biosecurity and cytocompatibility evaluation.
OBJECTIVE:To observe the biosecurity of the shape memory polymer based on D,L-poly(lactic acid).
METHODS:(1) Bacterial endotoxin test:polymer extract, endotoxin working standard solution and checking
standard water were added into limulus reagent, respectively. (2) Sensitization test:Polymer extract+Freund’s complete adjuvant+physiological saline and Freund’s complete adjuvant+physiological saline were injected into the scapula of Kunming mice. After induction by intradermal injection, local induction and excitation, stimulate skin erythema and edema degree were observed in animals. (3) Acute toxicity test:Kunming mice received intraperitoneal injection of 100%, 50%, 25%polymer leaching solution and physiological saline, respectively. (4) 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay for cel proliferation:The direct method was that human umbilical cord vascular endothelial cel s were inoculated onto the polymer film, lactic acid and glass, respectively;the indirect method was that human umbilical cord vascular endothelial cel s were inoculated into the polymer leaching solution, acrylamide solution and 1640 culture solution.
RESULTS AND CONCLUSION:This shape memory polymer based on D,L-poly(lactic acid) is free of bacterial contamination in compliance with the biosecurity standards, and it has no al ergenic and toxicity but has good cytocompatibility.

Objective To evaluate the structure and stiffness of the common carotid artery (CCA) in patients with obstructive sleep apnea syndrome (OSAS) by RFQIMT and RFQAS technology and analyze the relationships between the parameters of CCA and cardiovascular risk factors.Methods 113 participants with habitual snoring suspected OSAS were divided into control group,mild,moderate and severe OSAS groups according to apnea hypopnea index(AHI)＜5,5-20,20-40,＞40 event/hour respectively.Carotid parameters included intima-media thickness (IMT),diameter (D),distension (Dis),distensibility coefficient (DC),compliance coefficient (CC),pulse wave velocity (PWV),stiffness index α and β were collected by RFQIMT and RFQAS.Multivariate linear regression analysis was applied to analyze the relationships between CCA parameters and cardiovascular risk factors.Results ①The clinical characteristics:blood pressure had significant difference among the four groups (P ＜0.05).SO2,SO2 min decreased and T90,ODI increased significantly in mild,moderate and severe group (P ＜0.05).②The structure parameters of CCA:IMT,D and plaques had no significant difference among the four groups (P ＞0.05).③The elasticity parameters of CCA:Compared with control group,Dis increased significantly in mild group (P ＜0.05).PWV,α,β increased significantly in moderate group (P ＜ 0.05).Compared with mild group,PWV,α,β increased significantly in moderate group (P ＜0.05).Compared with moderate group,α,β increased significantly in severe group (P ＜0.05).④By multivariate linear regression analysis,age was an independent predictor of IMT,Dis,D,CC,PWV,α,β(P ＜0.05).A blunted nocturnal fall was an independent predictor of D,DC,CC,PWV (P ＜0.05),SBP,DBP and PP of daytime had an important effect on D (P ＜0.05).SO2 was independently correlated with PWV (P ＜0.05).PP was an independent predictor of PWV,α,β (P ＜0.05).Smoking was an independent predictor of plaque (P ＜0.05).Conclusions ①Stiffness is damaged earlier than morphology of CCA in patient with OSAS.②PP,a blunted nocturnal fall and SO2 are correlated with stiffness of CCA significantly.It indicates that abnormal circadian blood pressure rhythm and hypoxia are associated significantly with stiffness of CCA in patient with OSAS.

Objective To compare the efficacy of the laryngeal mask airway Classic (CLMA), Streamlined Liner of Pharyngeal Airway (SLIPA) and laryngeal mask airway ProSeal (PLMA) in patients undergoing laparoscopic surgery. Methods One hundred and twenty-three ASA Ⅰ or Ⅱ patients aged 20-64 yr undergoing elective laparoscopic surgery were randomly divided into 3 groups: CLMA group (group C, n =41 ), SLIPA group (group S, n =42) and PLMA group (group P, n =40). Laryngeal mask was inserted after induction of anesthesia with sufentanil 0.3 μg/kg, atracurium 0.5 mg/kg and propofol 2 mg/kg. Mll the patients were ventilated with intermittent positive-pressure ventilation. Anesthesia was maintained with contiunous infusion of propofol 6-8 mg· kg-1· h-1 and with supplementary administration of sufentsnil 0.1-0.2 μg/kg and atracurium 0.2 mg/kg as required. The degree of difficulty in inserting the laryngeal mask was evaluated. The rate of successful placement at first attempt, device placement time, recovery time and complications were recorded . Peak inspiratory pressure (PIP) and the number of patients with an airway sealing pressure less than PIP were recorded before pneumoperitoneum and when intra-abdominal pressure achieved 12 mm Hg. Results The placement was easier and the placement time and recovery time were significantly shorter in group S, and the placement time was significantly longer,the airway sealing pressure was significantly higher and the number of patients with an airway sealing pressure less than PIP was lower in group P than in group C ( P ＜ 0.05). The placement time and recovery time were significantly longer, the placement was harder, the airway sealing pressure was significantly higher, and the number of patients with an airway sealing pressure less than PIP was lower in group P than in group S ( P ＜ 0.05). PIP was significantiy higher when intra-abdominal pressure achieved 12 mm Hg than that before pneumoperitoneum in all the three groups ( P ＜ 0.05). There was no significant difference in the incidence of complications and rate of successful placement at first attempt among the three groups ( P ＞ 0.05). Conclusion All the three airway devices can provide adequate ventilation during operation, with fewer complications. SLIPA placement is easiest. PLMA can assure good airway sealing and is most suitable for patients undergoing laparoscopic surgery.