Objective To investigate the relationship between serum 25-hydroxyvitamin D level and gestational diabetes mellitus (GDM).Methods The fasting plasma glucose,fasting insulin,25-hydroxyvitamin D,and high sensitive C-reactive protein (hs-CRP) levels in the normal glucose tolerance group and gestational diabetes mellitus (GDM) group were measured.The homostasis model assessment insulin resistant (HOMA-IR) and homostasis model assessment β cell (HOMA-B) were calculated for assessing the insulin resistance and β-cell function.The relationship between 25-hydmxyvitamin D and hs-CRP,HOMA-IR,and HOMA-B were analyzed.Results The level of 25-hydroxyvitamin D in the GDM group [(2.16 ± 0.38) nmol/L] was significantly lower than that in the normal glucose tolerance group [(4.13 ±0.79) nmol/L](P =0.001).Serum 25-hydroxyvitamin D level was negatively correlated with hs-CRP (r =-0.448,P =0.002) and HOMA-IR (r =0.396,P =0.004),but was positively related with HOMA-B (r =0.495,P =0.001).Conclusions The serum 25-hydmxyvitamin D level remarkably decreases in GDM patients.Vitamin D deficiency may cause the functional damage of beta cell of islet,increase insulin resistance,and thus contribute to the development of GDM.

Objective To observe the expression of oxidized purine nueleoside triphosphatase MTH2 in the hippocampi of senescence-accelerated mouse P8(SAMP8). Methods Randomly selected SAMP8 and its control strain SAMRl aged 1-,4-,8-and 12-month and performed immunohistochemisry and Western blot analysis to explore the expression changes of MTH2 in the 2 groups of mice. Results The MTH2 protein was detected in cytoplasm and nuclei of neurons throughout the whole hippocampus of SAMRl at all ages.There were no obvious changes of SAMR1 in both CA1 and CA3 subregions,but an age-related decline of MTH2 protein in both regions of SAMP8 was found.The optieal density(OD)value of Cal hippoeampus(0.0473),CA3 hippoeampus (0.0510)were significantly less in 8-month old mice than in the 4-month old[CA1:0.0619,CA3:0.06803(all P＜0.05).By immunoblot analysis,the grey values of MTH2 expression were 0.529,0.313,0.032 in hippoeampus of 4-12 months-old SAMP8 mice,and significantly Iower than in the age-matched SAMR1 mice(all P＜0.05). Conclusions MTH2 deficiency may be a new factor involved in the accelerated aging and in deficits of learning and memory ability in SAMP8.

Objective To compare dosimetrie difference of treatment planning of three-dimensional conformal radiotherapy (3D-CRT) and simplified intensity-modulated radiotherapy (slMRT) for non-small cell lung cancer (NSCLC). Methods Ten NSCLC patients treaded by radiotherapy were investigated. 3D-CRT and slMRT plannings were designed for each patient. The prescribed dose was 60 Gy(2 Gy/f), the 95 % of the planning target volume was received with this dose for each patient. The dose was computed with treatment planning system of ADAC Pinnacle3 using convolution/superpasition algorithm. Two plans were compared according to the homogeneity index (HI) and conformity index (CI) of dosimetry in the planning target volume and the parameters of dose-volume histogram (DVH) in normal tissue. Results In the terms of HI and CI, sIMRT had slight vantages over 3D-CRT. In the terms of DVH, compared with 3D-CRT, mean lung dose, V5, V10 and V20 of slMRT reduced by 14.81 %, 17.88 %, 19.15 % and 27.78 %, respectively. The dosimetric differences were not statistically significant between 3D-CRT and sIMRT in terms of esophagus, heart and spinal cord. Conclusions For NSCLC, sIMRT has some irreplaceable advantages over 3D-CRT and is worth spreading in clinical work.

Objective To explore the efficacy of tentorium cerebelli hiatus incision for treatment of severe brain injury complicated with tentorial herniation. Methods Tentorium cerebelli hiatus incision was performed in 38 patients of severe brain injury with secondary brain stem damage resulted from tentorial herniation after intracranial hematoma evacuation and bone flap craniotomy decompression. The changes of four sides cistern, ambient cistern and interpeduncular cistern before and after operation were observed. Results There was a siginificant difference in the appearance ratio of four sides cistern, ambient cistern and interpeduncular cistern between the preoperation and postoperation(P

It is a trend that clinical researchers overemphasize on hypothesis testing and the P value. However, P value has some limitations in the presentation of study results. Power is a tool for study design and results explanation, especially for negative results. Confidence interval contains more information for clinical results than P value. P value, power, and 95% confidence interval should be provided in the clinical reports to facilitate the interpretation of the results.

Objective:To investigate the neuroendocrine properties of adrenalcortical tumors.Methods: We retrospectively reviewed the clinical data of 99 adrenalcortical tumor patients,who were treated in Changzheng Hospital form June 1999 to June 2005.Expression of neuron specific enolase(NSE),chromogranin A(CgA) and synaptophysin(Syn) proteins were examined by immunohistochemistry(S-P method) using monoclonal antibodies.The general data of patients,including the age,symptoms,laboratory findings,and pathological types,were collected and subjected to statistical analysis with SAS v6.12 software.Results: The expression of all the above 3 proteins was found in adrenalcortical adenoma tissues,with the positive rate of NSE being 80%,the positive rate of CgA being 48.9%,and the positive rate of Syn being 75.6%;the positive rates in the adrenalcortical carcinoma tissues were 77.8%,22.2%,and 77.8%,respectively;and those in the normal adrenal tissues was 20%,0%,and 10%,respectively.The positive rates of 3 proteins in adrenalcortical tumors was significantly higher than those in the normal adrenal tissues(P

Objective To observe the course of motor related activation cortex after unilateral subcortical ischemic stroke. Methods6 healthy volunteers and 3 patients with solitary lacunar infarction in subcortical region underwent blood-oxygen level dependent functional MRI （BOLD-fMRI） as a block design of sequential finger tapping task. The data were analyzed with Statistical Parametric Mapping (SPM2). The activated voxels and the laterality index (LI) were calculated. The patients were assessed with the Fugl-Meyer Assessment of upper limb after scanning, and were scanned again 8 months after stroke. ResultsThe activated cortices in patients were more extensive than that of volunteers. In the early stage of stroke, the activation cortex involved the bilateral sensory motor cortex (SMC) in all the patients, but various in other regions. In the late stage, the ipsilateral activations decreased while the contralateral activation increased in SMC. The LI of hemisphere, SMC, and M1 is higher than the early stage. ConclusionThe motor related activation gradually localized to the contralateral SMC with motor function recovery.

Objective Increased renal mast cells have been found in significant correlation with clinicopathological features of diabetic nephropathy ( DN) .However, the exact pathological significance of mast cells still remained to be elucidated.As one of the most abundant serine proteases, tryptase is specifically expressed by mast cells.The study was to observe the expression of tryptase in the urine of patients with diabetic nephropathy and realize the pathological significance of urinary tryptase and renal mast cells in the development of diabetic nephropathy. Methods Urine samples from 103 patients with diabetic nephropathy who were hospitalized at the clinical unit of the nephrology centre of Jingling Hospital from January 2012 to June 2013 were collected.According to concentra-tion of urinary albumin excretion rate, the patients were conducted to early-stage DN group (microalbuminuria,n=10), middle-stage DN group (proteinuria stage, n=31) and end-stage DN group (renal insufficiency stage,n=62).Meanwhile, urine samples from 20 normal persons were taken as the normal control group.Tryptase level in each urine sample was measured by using an ELISA kit.The average tryptase levels were compared among different groups and the correlation between urinary tryptase level and clinical indices was analyzed. Results ①In most cases, tryptase was not detected in the urine samples from normal persons(0.7 ±1.4 ng/mg creati-nine).However, the urinary trypatse level increased significantly with the development of diabetic nephropathy (11.6 ±10.5 ng/mg creatinine for early stage, 29.7 ±19.2 ng/mg creatinine for middle stage, and 44.6 ±43.4 ng/mg creatinine for late stage group).②The urinary tryptase level was found in significant correlation with ser-um creatinine (r=0.325, P<0.01), serum cystatin C (r=0.391, P<0.01), serum urea nitrogen (r=0.27, P<0.01), 24 hour uri-nary protein (r=0.389, P<0.01), urine C3 (r=0.276, P<0.05), urine retinol-binding protein (r=0.365, P<0.01), urine lysozyme (r=0.461, P<0.01), urine N-acetyl-β-glucosaminidase level (r=0.568, P<0.01), urinary kidney injury molecule-1 (r=0.434, P<0.05) and interleukin-18 level (r=0.375, P<0.05).No significant correlation was found between urinary tryptase level and age, gender, fasting blood sugar, postprandial blood sugar, HbA1c, triglyceride, high density lipoprotein or low density lipo-protein. Conclusion Mast cells play an important role in the development of diabetic nephropathy and might be a novel and effective target for the treatment of DN.

Objective:To study the effect of portal vein occlusion on intestinal mucosal barrier in rats and the protection of ulinastatin to the injury,to present the experimental data for the clinical surgery.Methods:70 Sprague-Dawley rats were randomly divided into controlled group (n=10),operation group (n=30) and operation+medication group (n=30).The portal vein were occlused 40 min in the operation groups and operation+medication groups.2ml blood from portal vein,lymph nodes around appendix,1cm small intestine wall were taken for endotoxin levels,bacterial translocation and pathiology examinations in the all rats 280 mins after operation.The mocusal barrier and microscopic structure of intestine were observed.Results:Compared between the control group and the operation group,endotoxin levels,bacterial translocation rates rise greatly and gut structure change obviously in the latter.Compared between the operation group and operation+medication group,the former changes is also obvious.Conclusion:The occlusion of portal vein can leads the decrease of intestine mocusal barrier and the increase of its permeability.Ulinastatin has a good protective effect on the damages above.