Obesity is not only the high risk factor of diabetes mellitus,coronary heart disease and hypertension,but also a cause of renal damage.Diabetic nephropathy is one of the most frequent chronic microvascular complications of diabetes mellitus,and one of the leading causes of end-stage kidney failure.It is documented that the obese patients with type 2 diabetes may have obviously multiple metabolic abnormalities and are more prone to develop diabetic nephropathy.This article summarized the pathogenetic mechanisms of kidney injury in diabetic obese patients and provided some ideas in the medical therapy of diabetic nephropathy.

Objective To investigate the relationship between serum Leptin levels and insulin resistance.Methods During 2001-10~2002-08 fasting serum Leptin concentrations were measured with RIA in 196 cases(including 118 type 2 diabetes,78 controls),and height,body weight were measured to calculate body mass index(BMI).Results HbA_1c,SBP,TG,Leptin were correlated with ISI,Leptin concentration were higher in type 2 diabetes than in controls;Leptin concentration was significantly increased in obese subjects,whereas in type 2 diabetes serum Leptin concentration had no significant difference between obese subjects and non-obese subjects.Conclusion Most of obeses subjects have insulin resistance,whether obesity or not,the patients type 2 diabetes have some kind of insulin resistance.

Subluxation of hip, sprain, epilepsy, etc. are serious problems for cerebral palsy children during physiotherapy. This paper would review the reasons of these complications and the managements.

Objective To describe an ideal technique to repair full-thickness lower lid marginal defects in a one-stage procedure. Methods The buccal rotation flap and the nasal septal chondromucosal flap were used in one-stage operation to repair full-thickness lower eyelid defect. Results Eleven patients including 6 male patients and 5 female patients underwent lower eyelid reconstruction since January 2000.The age ranged from 29 to 64 years with average 43. Seven patients with full-thickness lower eyelid defect were caused by basal cell carcinoma excision, while four patients were caused by trauma. All the fullthickness lower eyelid defects were reconstructed by using the buccal rotation flap and the nasal septal chondromucosal flap in one-stage operation. All the flaps survived completely after operation. There were no other complications excepting that two patients developed to mild lower eyelid retration after six months. Conclusion The technique consisting of the buccal rotation flap and the nasal septal chondromucosal flap is a simple and useful alternative procedure to close full-thickness defects in the lower eyelid.

Objective To study the protective effects of vitamin E combined with Rhodiola rosea on the injury in mice skeletal muscle through hypoxia with exercise training and research the mechanism of action.Methods Forty ICR mice were randomly divided into control group and observation group,20 mice in each group.The control group was given Vitamin E (40 mg·kg-1·d-1),and the observation group was given Vitamin E (40 mg·kg-1·d-1)combined with Rhodiola rosea (20 g·kg-1·d-1);the rats in the two groups were treated with hypoxia (11.3%) for 4 weeks (5 ℃,15 m/min,60 min/d) after 15-day drug using.After the last training,all the mice were euthanized and then detected the gene of Bax and Bcl-2 mRNA through the RT-PCR in the skeletal muscle and the activity of GSH-PX,SOD,ROS,the concentration of MDA in the skeletal muscle.During the period (pretrain and 1,2,4 weeks) of hypoxia combined with exercise training,the CK,LDH in the serum were detected.Results The expression of CK and LDH in the observation group were lower than those of the control group (P<0.05).The activity of GSH-PX and SOD in the skeletal muscle of the observation group was significantly higher than that of the control group (P<0.05),while the ROS and MDA were lower than those of the control group(P<0.05);the expression of Bax mRNA and Bax/Bcl-2 of the observation group was significantly lower than that of the control group(P<0.05).While the expression of Bcl-2 mRNA was significantly higher than that of the control group(P<0.05).Conclusion Rhodiola rosea combined with Vitamin E can inhibit the expression of apoptotic genes by correcting the oxidation and hypoxia imbalance under hypoxia.

Objective: To explore the genetic cause for abnormal pregnancies through detecting chromosomal copy number variations (CNVs) in abortic tissues by next generation sequencing (NGS). Methods: NGS technique was used to detect CNVs in abortion tissues. Parental chromosomal karyotypes were predicted based on the results. The aberrant chromosomal segments of the parents were accurately mapped by G-banding karyotyping analysis and fluorescence in situ hybridization (FISH). Results: In addition to numerical chromosomal aberrations, 12 microdeletion/microduplications were detected by NGS. For 8 families where both parents accepted chromosomal karyotyping, 4 carriers of chromosomal abnormalities were identified. One marker chromosome was missed by karyotyping analysis, and a mother was confirmed to carry a cryptic balanced translocation by FISH. Conclusion NGS can facilitate detection of cryptic chromosomal translocations in couples with repeated pregnancy failure and is of great value for detecting abnormal CNVs for its high sensitivity.

Objective: To observe the expression levels of PD-1/PD-L1 costimulatory molecules and explore the clinical significance in patients with chronic lymphocytic leukemia (CLL) . Methods: The expression of PD-1/PD-L1 in peripheral blood CD8⁺ T cells, CD4⁺T cells, CD19⁺B, and dendrites cells (DC) was detected by flow cytometry in 57 CLL patients and 20 healthy controls. The correlations of PD-1/PD-L1 expression with disease stage, CD38 expression, ZAP-70 expression, chromosome karyotype abnormality and β₂-MG expression were analyzed. Results: ①Compared with control, CLL patients, including 39 males and 18 females with the median age of (63.7±10.7) years, had no statistically significant difference in age and gender (P>0.05) . CLL patients had the higher PD-1/PD-L1 expression than healthy controls (P<0.05) . ②In Rai staging, the later the stage, the higher expression of PD-1/PD-L1 (P<0.05) . ③PD-1 expression in CD8⁺CD38⁺ group (11 cases) was higher than that in CD8⁺CD38^- group (46 cases) (P=0.004) , and CD8⁺ poor prognosis chromosome group (14 cases) also had significant higher PD-1 expression than CD8⁺good prognosis chromosome group (28 cases) (P=0.004) . ④The expression of PD-L1 was higher in CD38⁺group, ZAP-70⁺group, and poor prognosis group, as compared to that in CD38^-group (P=0.002) , in ZAP-70^-group (P<0.001) , in good prognosis group (P=0.023) . There was no correlation between the expression of PD-1/PD-L1 and β₂-MG (P>0.05) . Conclusion This data reveals that PD-1/PD-L1 was highly expressed in CLL patients. Its expression levels were correlated with Rai stage, CD38, ZAP-70, chromosome karyotype, but not with β₂-MG. PD-1/PD-L1 may be a prognostic factor in patients with CLL.

Objective:To explore the expression levels, clinical significances and prognostic evaluation value of T-cell immunoglobulin mucin-3 (Tim-3) and galectin-9 (Gal-9) in bone marrow cells of patients with newly diagnosed acute lymphocytic leukemia (ALL).Methods:Bone marrow samples from 30 newly diagnosed ALL patients admitted to First Affiliated Hospital of Xinjiang Medical University from September 2016 to September 2018 were selected, and peripheral blood samples from 20 healthy volunteers during the same period in the First Affiliated Hospital of Xinjiang Medical University were treated as the controls. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect mRNA relative expression levels of Tim-3 and Gal-9. Differences in mRNA expression of Tim-3 and Gal-9 among ALL patients with varied clinicopathological characteristics were compared. Overall survival (OS) analysis was performed by using the Kaplan-Meier method, Cox proportional hazards model was used to make univariate and multivariate survival analysis.Results:mRNA relative expression levels of Tim-3 and Gal-9 in 30 newly diagnosed ALL patients were higher than those in the healthy control group (2.86±0.47 vs. 0.45±0.05, t = 21.65, P<0.05; 9.79±0.58 vs. 0.96±0.23, t = 63.24, P<0.05). mRNA relative expression level of Tim-3 had statistically significant differences in patients with different ages, France-America-Britain (FAB) Cooperative Group classification, hazard grades and central nervous system invasion (all P<0.01). There were statistically significant differences in mRNA relative expression level of Gal-9 for patients with different ages, FAB Cooperative Group classification, white blood cell count (WBC), central nervous system invasion and NOTCH1 mutation (all P<0.01). All patients were grouped by mRNA relative expression levels of Tim-3 and Gal-9, and patients in high Tim-3 expression group (≥2.86) had worse overall survival (OS) compared with that for patients in low Tim-3 expression group (<2.86) ( P = 0.048). Patients in high Gal-9 expression group (≥9.79) had worse OS compared with that for patients in low Gal-9 expression group (<9.79) ( P = 0.031). Moreover, the OS in Tim-3 and Gal-9 both high expression group was worse than that in Tim-3 and Gal-9 both low expression group and in the low expression group of either of them (all P<0.05). There was no statistically significant difference in OS between the high Tim-3 expression with low Gal-9 expression group and the high Gal-9 expression with low Tim-3 expression group ( P > 0.05). Multivariate Cox regression analysis revealed that peripheral blood WBC≥11.4×10 9/L, BCR-ABL gene mutation, central nervous system invasion, and high expression of Tim-3 and Gal-9 were independent risk prognostic factors of OS for newly diagnosed ALL patients (all P<0.05) . There was a positive correlation between the expression levels of Tim-3 and Gal-9 ( r = 0.788, P<0.01). Conclusions:The high expression of Tim-3 and its ligand Gal-9 are independent effecting factors of poor prognosis in newly diagnosed ALL patients. The expression levels of Tim-3 and Gal-9 can be served as a potential prognostic indicator for ALL patients.

Objective To investigate the effect ofolipoprotein E (ApoE) mimetic peptide on neural apoptosis and autophagy and their mechanisms in mice after traumatic brain injury (TBI).Methods A total of 40 health adult male C57BL/6J mice were randomly divided into sham-operated group,TBI+normal saline (NS) group,TBI+COG1410 (1 mg) group and TBI+COG1410 (2 mg) group (n=10).The TBI models of moderate mice were constructed by controlled cortex impact (CCI) devices in the later three groups and mice in the sham-operated group were performed bone window operning only.Thirty min after model making,COG1410 treatment was given by intravenous injection of COGl410 via the tail vein at a dose of 1 mg/kg.d or 2 mg/kg.d.Mice in sham-operated group and TBI+NS group were injected with equal sterile NS instead.Neurological functions were tested 3 d after TBI by rolling-bar test and modified neurological severity scale (mNSS).Neural apoptosis was analyzed by TUNEL and autophagy protein LC3 expression in the neurons of cortex around the lesion focus was detected by immunofluorescence.Western blotting was employed to detect the expressions of apoptosis-related proteins (Bax,Bcl-2 and Caspase-3) and autophagy proteins (Beclin-1,LC3-Ⅰ and LC3-Ⅱ),and changes of Akt,mTOR,phosphorylated-(p-) Akt,p-mTOR levels.Results As compared with those in the sham-operated group,significantly shortened rotarod latency,significantly increased mNSS scores,significantly increased Bax and Caspase-3 protein expressions,significantly decreased Bcl-2,significantly increased Beclin-1 and LC3-Ⅱ protein expressions and number of TUNEL postive neurons,and statistically increased p-Akt and p-mTOR levels in the TBI+NS group were noted (P＜0.05).As compared with those in the TBI+NS group,significantly increased rotarod latency,significantly decreased mNSS scores,significantly decreased Bax and Caspase-3 protein expressions,significantly increased Bcl-2,significantly decreased Beclin-1 and LC3-Ⅱ protein expressions and number of TUNEL postive neurons,and statistically increased p-Akt and p-mTOR levels in the TBI+COG1410 (1 mg) group and TBI+COG 1410 (2 mg) group were noted (P＜0.05).As compared with those in the TBI+COG 1410 (1 mg) group,significantly increased rotarod latency,significantly decreased mNSS scores,significantly decreased Bax and Caspase-3 protein expressions,significantly increased Bcl-2 expression,significantly decreased Beclin-1 and LC3-Ⅱ protein expressions and number of TUNEL postive neurons,and statistically increased p-Akt and p-mTOR levels in the TBI+COG1410 (2 mg) group were noted (P＜0.05).Conclusion ApoE peptide is effective in reducing the excessive neuronal apoptosis and neurological dysfunctions caused by excessive neuronal autophagy after TBI,which is associated with the modulation of Akt/mTOR related pathway.

Objective To explore the altered expression of circular RNA (circRNA) and mRNA in the mouse cortex in the early phase of subarachnoid hemorrhage (SAH) and possible biological functions of the circRNA in early brain injury (EBI).Methods A total of 18 C57BL/6J male mice were randomly divided into a sham and a SAH group (n=9).SAH models were prepared by endovascular perforation.Total RNAs of brain samples were extracted to construct the cDNA library 24 h after operation.RNA-sequencing (RNA-seq) was carried out by HiSeqTM 2500 User Guide and followed by RT-qPCR for confirmation.Reads were aligned to the mouse transcriptome to obtain expression profiles ofcircRNA and mRNA.Bioinformatic study included GO analysis,KEGG pathway analysis and forecast of targeted miRNA of circRNA.Results A total of 26 circRNA (6 up-regulated and 20 down-regulated) and 804 mRNA (396 up-regulated and 408 down-regulated) were significantly changed.These altered mRNA were mainly related to regulation of neuronal synaptic plasticity,inflammatory and immune response.Bioinformatics showed that some significantly altered circRNA contained binding sites for many miRNA.The RT-qPCR analysis of 4 randomly selected circRNA (circFoxj3,circSetbp1,circArpp21 and circ2010111 I01Rik) confirmed the accuracy of RNA-seq.Conclusions SAH alters the expression of circRNA in mouse cortex and the differentially expressed circRNA may be involved in regulation of EBI following SAH,promising a potential therapeutic target for the diagnosis,treatment and prognosis of SAH.