Objective To investigate the efficacy of aripiprazole addition therapy on adiponectin and leptin in schizophrenia patients with olanzapine-induced weight gain. Methods Schizophrenia patients with clinically significant weight gain induced by olanzapine were randomly divided into two groups:treated with olanzapine+aripiprazole (5 mg/d, n=48) or olanzapine+placebo (n=46). The level of FBS, TG, TC, adiponectin, leptin, the body index (BMI) and the insu?lin resistance index (HOMA-IR) were measured before and 4, 8 and 12 weeks after treatment. Results Adiponectin in?creased and leptin as well as HOMA-IR decreased in olanzapine+aripiprazole group after 4, 8 and 12 weeks treatment (P<0.05). However, FBS, TG and TC decreased and BMI increased only after 8 and 12 weeks treatment(P<0.05). In olanzapine+placebo group, the dadiponectin decreased and leptin, HOMA-IR as well as BMI increased after 8 and 12 weeks treatment(P<0.05). In olanzapine + aripiprazole group the adiponectin, leptin and HOMA-IR of 4, 8 and 12 weeks and BMI of 8 and 12 weeks were different from olanzapine + placebo group(P<0.05). Conclusions In schizo?phrenia patients with olanzapine-induced weight gain, aripiprazole addition therapy can ameliorate the HOMA-IR and BMI probably through the regulation of adiponectin and leptin.

Objective To explore the value of intravoxel incoherent motion (IVIM) imaging in evaluating diffusion and perfusion variations in subacute brain infarction.Methods MRI data of 35 patients with subacute brain infarction were analyzed retrospectively,including routine DWI,IVIM imaging and three-dimensional arterial spin labeling (3D-ASL) sequence.The ADC maps were obtained by routine DWI sequence.Pure molecular-based diffusion coefficient (D) maps,pseudo diffusion coefficient of perfusion (D*) maps and perfusion fraction (f) maps were obtained by IVIM sequence.Cerebral blood flow (CBF) maps were obtained by 3D-ASL sequence.ADC,D,D*,f,CBF values and the relative values (rADC,rD,rD*,rf,rCBF) of brain infarction lesion and contralateral mirror area were calculated.All the parameters between brain infarction lesion and contralateral mirror area were compared.The correlations were analyzed between rADC value and rD,rD*,rf values respectively,as well as between rCBF value and rD,rD*,rf values respectively.Results Quantitative analysis showed significant decreases of ADC,D,D*,f and CBF values in the brain infarction lesion compared with those in the contralateral mirror area (all P＜0.05).There were positive correlations between rADC value and rD,rf values (r=0.687,0.601,P=0.005,0.018).And the positive correlation was found between rCBF value and rf value (r=0.581,P=0.022).Conclusion IVIM imaging can concurrently provide the perfusion and diffusion informations of subacute brain infarction patients,which is helpful to further elucidate the mechanisms of subacute brain infarction.

Objective To assess the value of apparent diffusion coefficient (ADC)map with low b-value to monitor the ablated tissue after high-intensity focused ultrasonic (HIFU)treatment for uterine fibroids.Methods 25 patients with 34 uterine fibroids were treated with HIFU.All patients underwent the routine MRI scans (including pre-and post-contrast scanning)and monoexponential model DWI with b values of 150,600 and 1 000 s/mm2 before the surgery and within 24 hours after the surgery.The mean ADC values with different b-values of the ablated and non-ablated tissues between pre-and post-treatment were analyzed by one-way ANOVA test.The consistency of the ablation area between ADC maps with different b-values and contrast enhancement MRI were evaluated. Results With the b-value of 150 s/mm2 ,the mean ADC value of the ablated tissue was (1.48±0.27)×10-3 mm2/s,which was less significantly than that of pre-treatment (2.06±0.21)×10-3 mm2/s and non-ablated tissue (1.98±0.23)×10-3 mm2/s (P<0.05). However,there were no significant differences in ADC values with the b values of 600 s/mm2 and 1 000 s/mm2 among those areas (P>0.05).A fine consistency of the ADC map with the low b-value (150 s/mm2 )was found with non-perfusion volume on contrast-enhanced T1 WI,which was superior to that with high b-values (600 s/mm2 and 1 000 s/mm2 )(P<0.05).Conclusion ADC map with low b-value (150 s/mm2 )can be used to evaluate the blood-supply changes and ablated volume of uterine fibroids indirectly,which helps to assess the treatment effect of HIFU.

Bones are important supporting structure of human body. Impulse response method is a kind of vibration analysis technology which can be used to analyze dynamic characteristics of human bones. Along with the continuous development of signal processing and computer technology, impulse response method is applied more and more in bone biomechanics research. The basic principle of impulse response method and its progress in bone biomechanics research are briefly summarized in this paper. The article also discussed the pulse response method research direction.

The application principle and procedure of reverse engineering and rapid prototyping techniques are introduced in this paper. The description is concentrated on the applications of the above techniques in medical field, especially in reconstructive surgery of mandibular bone defect.
Biomedical Engineering ; Bone Substitutes ; Computer Simulation ; Computer-Aided Design ; Humans ; Mandible ; surgery ; Mandibular Prosthesis Implantation ; methods ; Reconstructive Surgical Procedures ; methods

ObjectiveTo investigate the role of overexpressed proinflammatory cytokines in the pathogenesis of cerebral palsy (CP).MethodsLevels of tumor necrotic factor-α (TNF-α) and interleukin-6 (IL-6) in serum of 31 CP children, 20 healthy children (as controls), 37 neonates with CP risk factors such as hypoxic-ischemic injury and/or perinatal infection, and 20 healthy neonates (as controls) were measured by enzyme-linked immunosorbent assays (ELISA) retrospectively.ResultsLevels of TNF-α and IL-6 of CP children and neonates with CP risk factors were significantly higher than that of healthy controls (P<0.05). TNF-α level of CP children was significantly higher than that of neonates with CP risk factors (P<0.05), but there was no significant difference in IL-6 level between two groups.ConclusionOverexpressed proinflammatory cytokines play an important role in the pathogenesis of CP and may be an independent risk factor of CP.

Objective:To investigate the effect of the adoptive transfer of CD4+CD25+Foxp3+regulatory T cells ( iTregs) induced by 5-aza-2′-deoxycytidine (5AzaD) on pregnant outcome of the abortion-prone mice.Methods:Sixty cases of female CBA/J × male DBA/2J abortion-prone matings were taken as study group,the CD4+T cells from spleen of twenty female CBA/J mice were separated by magnetic activated cell sorting (MACS),5AzaD was applied to the conversion of CD4+CD25-T cells to iTregs,the expression of Foxp3 in Tregs was characterized by flow cytometry analysis before and after epigenetic modification.The purified iTregs were injected into abortion-prone mice on day 1 or 4 of pregnancy,respectively,which were used as therapy groups,and then the embryo resorption rate was counted on day 14 of pregnancy.Results:After the treatment of 5AzaD,the percentage of iTregs in CD4+T cells was (41.50±8.03)%.The embryonic absorption rates of the two therapy groups were 10.47%(on day 1 of pregnancy) and 21.69%(on day 4 of pregnancy) ,respectively ( P<0.05 ) .Conclusion: Epigenetic modication of CD4+CD25-T cells may solve the problem of nTregs deficiency,particularly adoptive therapy of 5AzaD-induced iTregs at early stage of pregnancy can maintain normal pregnancy.

At present, there are still some problems in the standardized residency training. Some standardized training bases often regard the resident trainees as ordinary practitioners, and devote their time and energy to the daily medical procedural work without giving enough training and teaching, ignoring the basic skills training of resident trainees. Therefore, this study constructed an active knowledge push system based on business scenarios. The system mainly includes three parts: sensitive operation identification layer, knowledge index layer and resource push layer in order to cultivate the norms of diagnosis and treatment of standardized training students and reasonably solve the problem of inconvenient resource acquisition in clinical work. Through the preliminary application, it was found that the system has effectively improved the mini-clinical evaluation exercise (Mini-CEX) score of the trainees and achieved good results.

BACKGROUNDThe value of gamma probes in the surgical treatment of secondary hyperparathyroidism (sHPT) was determined. The aim of this study was to enhance the rate of successful total parathyroidectomy in patients with sHPT using intraoperative gamma probe investigations.

METHODSWe retrospectively analyzed the clinical data of 48 sHPT patients between May 2007 and September 2011. Preoperative (99)Tc(m)- methoxyisobutyl isonitrile (MIBI) scintigraphy and high-frequency ultrasonography were used for parathyroid localization. Thirty-five patients (group I) underwent conventional neck exploration and open parathyroidectomy. Thirteen patients (group II) underwent gamma probe-guided total parathyroidectomy and parathyroid transplantation. The two groups were compared in terms of the number of parathyroid resections, operative time, and postoperative changes in the blood levels of parathyroid hormone (PTH), calcium, and phosphate.

RESULTSThe clinical manifestations, PTH and calcium levels, age distribution, and clinical characteristics did not differ between the two groups. The accuracy of preoperative (99)Tc(m)-MIBI scintigraphy (89.74%) for the diagnosis of hyperparathyroidism did not differ from that of ultrasonography (81.25%). However, the accuracy of (99)Tc(m)-MIBI scintigraphy (66.67%) for localizing hyperfunctioning parathyroids was significantly lower than that of ultrasonography (76.86%). The operation time was significantly longer in group I ((120 ± 25) minutes) than in group II ((90 ± 30) minutes). The accuracy of parathyroid identification was significantly higher in group II (92.59%) than in group I (80.39%). On average, significantly fewer parathyroid specimens were obtained in group I (2.5 ± 0.5) than in group II (3.5 ± 0.5). Compared with group I, group II showed a significant increase (15.4%) in the number of parathyroid resections. The PTH, calcium, and phosphate levels significantly decreased postoperatively in all patients.

CONCLUSIONSIntraoperative gamma probe examination confirmed that the excised specimen was parathyroid tissue and improved the accuracy of parathyroid resection. The parathyroidectomy rate was increased by 15.4% due to the use of these probes. However, the probes did not detect all ectopic parathyroids, and further research is required to clarify the underlying reasons.

Adult ; Female ; Humans ; Hyperparathyroidism, Secondary ; surgery ; Male ; Middle Aged ; Organotechnetium Compounds ; therapeutic use ; Parathyroidectomy ; methods ; Retrospective Studies ; Ultrasonography ; methods

ObjectiveTo investigate the effect and potential mechanism of Dihuangyin on 2， 4-dinitrochlorobenzene （DNCB） -induced model mice with atopic dermatitis （AD）. MethodA mouse model with AD was established by repeatedly stimulating the back skin of mice with DNCB. After successful modeling， the mice were randomly divided into model group， Runzao group （0.78 g·kg^-1）， and high， medium， and low dose （40.30， 20.15， and 10.08 g·kg^-1） groups of Dihuangyin， with 12 mice in each group， and the blank group consisted of 12 mice， 72 in total. The administration groups were given the corresponding liquid by dose， and the blank group and model group were given the same dose of pure water by intragastric administration， once a day. The skin lesions and scratching times of mice were observed after continuous administration for two weeks. The back skin lesions of mice were stained with hematoxylin-eosin （HE） and toluidine blue to observe the pathology. The contents of serum immunoglobulin E （IgE）， interleukin-4 （IL-4）， interleukin-6 （IL-6）， and interferon-γ （IFN-γ） were detected by enzyme-linked immunosorbent assay （ELISA）. The mRNA expression levels of IFN-γ， IL-4， IL-6， Janus kinase 1 （JAK1）， and transcriptional activator 3 （STAT3） in skin lesion tissue were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The expressions of JAK1， phosphorylation（p）-JAK1， STAT3， and p-STAT3 proteins in skin lesion tissue were detected by Western blot. ResultCompared with the blank group， the back skin of the model group showed large-scale scab， dryness， erosion， hypertrophy with scratching， epidermal hyperplasia with hyperkeratosis and parakeratosis， hyperacanthosis with edema， and a large number of mast cell infiltration in the dermis， some of which were degranulated. The contents of IgE， IL-4， IL-6， and IFN-γ in the serum of mice were significantly increased （P<0.01）， and the protein expression levels of p-JAK1， STAT3， and p-STAT3 and mRNA expressions of IL-4， IL-6， IFN-γ， JAK1， and STAT3 in skin lesion tissue were significantly increased （P<0.01）. Compared with the model group， only a small amount of dryness and desquamation were observed in the back skin of mice in each administration group， and cell edema was reduced. The inflammatory infiltration was significantly reduced， and the number of mast cell infiltration was significantly decreased. The serum IgE， IL-4， IL-6， and IFN-γ of mice were decreased to varying degrees （P<0.05， P<0.01）. The protein expression levels of p-JAK1， STAT3， and p-STAT3 and mRNA expressions of IL-4， IL-6， IFN-γ， JAK1， and STAT3 in skin lesion tissue were significantly decreased， and the effect of high dose group of Dihuangyin was the best （P<0.01）. ConclusionDihuangyin can improve skin lesions and pruritus in mice with AD， and its mechanism may be related to the effective regulation of cytokines on the helper T cells （Th1）/Th2 axis by interfering with the JAK1/STAT3 signaling pathway and affecting skin barrier function.