Objective To analyze the effect of blood glucose control level on prognosis in cerebral infarction with stress hyperglycemia.Methods Ninety-two cases of new cerebral infarction within 24 h with stress hyperglycemia were divided into control group (46 cases) and observation group (46 cases).The blood glucose was controlled in 4.0-6.0 mmol/L in control group and 6.1-8.3 mmol/L in observation group.The hypoglycemia rate,infection rate,fatality rate,NIHSS score and Barthel score was observed in two groups.Results In control group,there were 14 cases cured,19 cases significantly improved,12 cases improved and 1 case invalid,while in observation group,there were 11,17,15,3 cases respectively,and the difference was not statisticly significant (P ＞ 0.05).The hypoglycemia rate,infection rate,fatality rate was 19.6％(9/46),10.9％(5/46) and 2.2％(1/46) respectively in control group,while in observation group was 4.3％ (2/46),15.2％ (7/46) and 4.3％ (2/46) respectively.The hypoglycemia rate was different between two groups(P ＜ 0.05),but the infection rate and fatality rate was not statistic difference between two groups(P ＞0.05).The NIHSS and Barthel score was not different between two groups before treatment (P ＞ 0.05).In control group the NIHSS after 1 week and 30 days after treatment and Barthel score 30 days after treatment was (15.47 ± 7.78),(9.85 ± 6.47),(67.18 ± 20.24) scores respectively,in observed group was (16.01 ±7.49),(10.17 ±5.84),(65.82 ± 19.93) scores respectively,which was improved compared with that pretreatment,but there was no significant difference between two groups(P ＞ 0.05).Conclusion The blood glucose controlled in 6.1-8.3 mmol/L does not increase the infection rate and fatality rate,but can reduce the hypoglycemia rate and promote neural function recovery in cerebral infarction with stress hyperglycemia.

Objective To investigate the effect and prognosis of intensive insulin therapy on cerebral infarction combined with hyperglycemia.Methods Seventy cases of cerebral infarction combined with hyperglycemia were divided into two groups by random number table method.Thirty-five cases in control group,were treated with insulin,and the blood glucose was controlled ＜ 11.1 mmol/L; 35 cases in intensive group,were treated by insulin pump,and the blood glucose was controlled in 4.4-8.3 mmol/L.The degree of neurological damage and improvement of daily life in two groups before and after treatment was compared by National Institutes of Health Stroke Scale(NIHSS) and modified Rankin Scale(mRS) scores.Insulin dosage,the time for reaching the standard,incidence of hypoglycemia,pulmonary infection rate and fatality rate was recorded in two groups.Results The NIHSS and mRS scores between two groups before treatment had no statistical significance (P ＞ 0.05),and after 30 d treatment,the NIHSS and mRS scores in control group [(8.29 ±2.74),(2.96 ±0.74) scores] and intensive group [(6.83 ±3.16),(2.02 ±0.62) scores] were obviously improved compared with those before treatment,and the improvement in intensive group was better than that in control group (P＜ 0.05).In intensive group,the insulin dosage and the time for reaching the standard was less than that in control group [(36.40 ± 6.91) U/d vs.(51.70 ± 9.86) U/d,(4.30 ± 0.87)d vs.(6.60 ± 1.24) d],incidence of hypoglycemia and fatality rate was lower than that in control group[5.7％ (2/35) vs.25.7％ (9/35),0 vs.8.6％ (3/35)],the difference was statisticly significant (P ＜ 0.05),but the pulmonary infection rate between two groups had no statisticly difference (P ＞ 0.05).Conclusion The curative effect of intensive insulin therapy on cerebral infarction combined with hyperglycemia is better,and is helpful to the neural functional recovery.

Objective To study the effect of sesamin on glucose metabolism in hyperlipidemia rats. Method The hyperlipidemia SD rats were established by high lipid diet. These rats were intervened by sesamin for 7 w,and then their serum lipids were determined. Fasting blood glucose (FBS),glycosylated hemoglobin (HbA1c),insulin,and the pathological changes of pancreas were observed. Results Sesamin could reduce serum TC,TG,LDL-C,apoB and insulin levels,appropriately increase HDL-C and apoA contents (P

MicroRNA (miRNA) negatively regulates gene expression at the post-transcriptional level.Studies find that the abnormal expression of miR-151-5p in various human tumors may play an important role in the development of human tumors,especially in the invasion and metastasis.Further studies of miR-151-5p contribute to a more in-depth understanding of tumor invasion and metastasis,which have potential value in tumor diagnosis,treatment and prognosis.

Objective To observe the curative effect of methylprednisolone combined with entecavir in treatment of hepatitis B virus (HBV) related early stage liver failure.Methods One hundred and twenty-six patients with HBV related early stage liver failure were divided into treatment group (68 cases) and control group (58 cases) by random digits table method.The patients in 2 groups were given conventional hepatinica treatment and entecavir antiviral treatment,but the patients in treatment group were added methylprednisolone and pantoprazole.The alanine aminotransferase (ALT),total bilirubin (TBil),albumin,prothrombin time (PT),HBV-DNA,tumor necrosis factor (TNF)-α,interleukin (IL)-6 levels were compared between 2 groups,and the adverse reaction of methylprednisolone was observed.Results The ALT,TBil,PT and albumin levels after the first,second,fourth,sixth and eighth week of treatment in treatment group were significantly better than those in control group,and there were statistical differences (P ＜ 0.05).There was no statistical difference in HBV-DNA between 2 groups (P ＞ 0.05).The TNF-α and IL-6 levels after the first and second week of treatment in treatment group were (4.13 ± 1.25) and (1.98 ± 0.67) p g/L,(3.21 ± 0.75)and (1.23 ± 0.29) μ g/L,and in control groups were (5.89 ± 1.78) and (3.67 ± 0.87)μ g/L,(4.12 ± 0.88) and (2.68 ± 0.81) μ g/L.The TNF-α and IL-6 levels in treatment group were significantly lower than those in control group,and there were statistical differences (P ＜ 0.05).The effective rate in treatment group (79.41％,54168) was significantly higher than that in control group (51.72％,30/58),the fatality rate in treatment group (2.94％,2/68) was significantly lower than that in control group (24.14％,14/58),and there were statistical differences (P ＜ 0.05).The adverse reaction of methylprednisolone in treatment group was not found.Conclusion The methylprednisolone combined with entecavir can improve liver function and survival rate in patients with HBV related early stage liver failure,and adverse reaction of methylprednisolone is rare.

Objective To evaluate the effect of sevoflurane pretreatment on the inflammatory response during renal ischemia-reperfusion (I/R) in rats.Methods Thirty pathogen-free male Sprague-Dawley rats,aged 12-14 weeks,weighing 220-260 g,were randomized into 3 groups (n =10 each) using a random number table:sham operation group (group S),I/R group and sevoflurane pretreatment group (group SP).Renal I/R was induced by clamping the left renal pedicle for 45 min followed by reperfusion in I/R and SP groups.In group S inhalation of 3％ sevoflurane in O2 was started at 30 min before I/R and maintained throughout the experiment.Venous blood samples were taken at 3 h of reperfusion for determination of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.The animals were then sacrificed and the left kidneys were removed for microscopic examination and for measurement of the content of tumor necrosis factor-apha (TNF-α),interleukin-6 (IL-6) and intercellular cell adhesion molecule-1 (ICAM-1) in renal tissues (by ELISA).Results Compared with group S,the serum BUN and Cr concentrations,severity of necrosis of renal proximal convoluted tubules (0 =normal,4 =necrosis of whole segment of proximal convoluted tubules),and contents of TNF-α,IL-6 and ICAM-1 were significantly increased in I/R and SP groups (P ＜ 0.05).Compared with group I/R,the serum BUN and Cr concentrations,severity of necrosis of renal proximal convoluted tubules,and contents of TNF-α,IL-6 and ICAM-1 were significantly decreased in SP group (P ＜ 0.05).Conclusion Sevoflurane pretreatment can protect kidney against I/R injury by inhibiting the inflammatory responses in the renal tissues of rats.

Objective To investigate the expression of activated ERK (p-ERK) and activated p38 (p-p38) in the keratinocytes of condyloma acuminata (CA) lesions. Methods Fifty cases of HPV 6/11 CA were diagnosed by in situ hybridization. The expression and distribution of p-ERK and p-p38 in CA lesions and 25 normal human skins (foreskins) were detected by immunohistochemistry technique (En Vision). Results ①The results showed that the expression of p-ERK and p-p38 in keratinocytes of CA lesions were significantly higher than those in normal epidermis (P

The blood samples of 102 type 1 diabetic children aged under 15 years and 127 normal children were collected and their genomic DNAs were extracted. The single nucleotide polymorphisms rs1990760 and rs35744605 of interferon induced with helicase C domain 1(IFIH1)gene were detected. The results showed that the allele of IFIH1 rs35744605 in diabetes group and control group was the wild type G allele. The frequency of IFIH1 rs1990760 A allele in diabetes group was higher than that in control group(22. 1％ vs 13. 0％ ,P=0. 015), suggesting that IFIH1 rs1990760 A allele is associated with type 1 diabetes in Tianjin area.

Objective To investigate the spectrum of CYP21A2 gene mutation and the correlation between genotype and phenotype in patients with 21-hydroxylase deficiency in Tianjin and surrounding areas.Methods Genomic DNA was extracted from the peripheral blood samples of the proband.Locus-specific PCR,direct sequencing of PCR amplification products,and multiplex ligation-dependent probe amplification were applied to detect pathogenic gene CYP21A2 and the relationship between genotypes and phenotypes was analyzed.Results (1) Of 35 patients with 21-hydroxylase deficiency,25 were classified as salt-wasting phenotype and 10 were simple virilizing phenotype.(2) 69 mutant alleles were detected in a total of 70 alleles in 35 patients.Only one mutant allele was detected in one patient.Two mutant alleles were detected in all other patients,with the mutation detection rate 98.6％.(3) A total of 6 types of mutations were detected,of which c.293-13C/A＞G (I2G) was the most common,accounting for 57.1％ (40/70),followed by 18.6％ (13/70) for large gene deletion or conversion,and 14.3％ (10/70) for p.I173N.In addition,a novel mutation,c.949C＞T (p.R317X),which has not been reported previously,was detected as a pathogenic mutation.(4) Correlation analysis of genotype and phenotype in 35 children showed that the phenotype predicted by genotype was consistent with the actual salt-wasting phenotype in 31 children,and those in three children were inconsistent with the actual clinical phenotype.Conclusion The mutation characteristics of CYP21A2 gene in patients with 21-hydroxylase deficiency in Tianjin and surrounding areas are slightly different from those reported in other regions in China.A mutation c.949C＞T has not been reported,which enriches the mutation spectrum of CYP21A2 gene and provide the foundation for genetic counseling and prenatal diagnosis.

OBJECTIVE: To explore the genetic basis for a child with 46,XY disorders of sex development (DSD) and explore its genotype-phenotype correlation. METHODS: The child was subjected to whole exome sequencing (WES), and exons 1 to 7 of NR5A1 were subjected to multiplex ligation-dependent probe amplification (MLPA) analysis. RESULTS: The patient presented with rudimentary vulva of a female with Tanner stage 1. B-mode ultrasonography has detected ovary and uterus. The child was found to have a chromosome karyotype of 46,XY. WES revealed that the patient has harbored heterozygous deletion of exon 5 of the NR5A1 gene, which was a novel pathogenic variant inherited from the mother. No abnormality was found in the father. CONCLUSION The main symptoms of 46,XY DSD children are insufficient external genitalia masculinization, for which variants of the NR5A1 gene are an important cause. WES has improved the detection rate of genetic variants and provided a solid basis for genetic counseling of the affected families.
Child ; Disorder of Sex Development, 46,XY/genetics* ; Disorders of Sex Development/genetics* ; Exons/genetics* ; Female ; Genetic Testing ; Heterozygote ; Humans ; Mutation ; Steroidogenic Factor 1/genetics*