Objective:To observe the effect of metformin on the expression of SIRT1 and UCP2 in rat liver of type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD), and discuss the pathogenesis of T2DM with NAFLD, and the treatment with and possible mechanism of metformin.Methods:Thirty-six male SD rats were randomly divided into a normal control group (group NC, n=12), a T2DM with NAFLD group (group MC, n=12), and a metformin group (group A, n=12). We established the model of T2DM with NAFLD rats by feeding high-fat and high-sugar diet and injecting STZ. After the success establishment of the model, the metformin group was given metformin 300 mg/(kg.d) for 8 weeks. At the end of the experiment, we measured FBG, ALT, AST, TC, TG, HDL-C, LDL-C, VLDL, FFAs, FINs and HOMA-IR respectively in group NC, MC and A. We observed the change of liver tissue pathology by HE, determined the expression of SIRT1 and UCP2 in rat liver by immunohistochemical method and real-time quantitative method. Results:FBG, ALT, AST, TC, TG, LDL-C, VLDL, FFAs, FINs and HOMA-IR were higher in group MC than in group NC (P<0.05), while HDL-C was obviously lower in group MC than in group NC (P<0.05). After the metformin treatment, the serum parameters in the rats had improved in group NC compared with in group MC (P<0.05). On immunohistochemical staining and mRNA level, the expression of SIRT1 was obviously lower in group MC than in group NC (P<0.05), and the expression of UCP2 was obviously higher in group MC than in group NC (P<0.05). After the metformin treatment, the expression of SIRT1 was higher than in group MC (P<0.05), and the expression of UCP2 was lower than in group MC (P<0.05). There was negative correlation between the expression of SIRT1 and UCP2 (r=-0.61, P<0.01).
Conclusion:The expression of SIRT1 is low and the expression of UCP2 is high in rat liver of T2DM with NAFLD. Metformin can increase the expression of SIRT1 and reduce the expression of UCP2, with negative correlation between the expression of SIRT1 and UCP2.

Objective To investigate the elasticity of the radial artery wall in type 2 diabetes mellitus (T2DM) patients with elastosonography. Methods A total of 37 patients with T2DM and 42 normal subjects were studied with elastosonography. The systolic diameter (Ds) and diastolic diameter (Dd) of the radial artery were measured, and the strain ratio of the blood in the radial artery to the wall of the radial artery was calculated. Results The strain ratio of the radial artery in T2DM group was significantly higher than that in normal group (P＜0.05). There was no significant difference in Ds and Dd of the radial artery between T2DM group and the control group (P＞0.05). Conclusion The early change of the radial artery wall elasticity in patients with T2DM can be assessed with elastosonography.

Objective To investigate the expressions of carbohydrate antigen 19-9(CA19-9), carbohydrate antigen 15-3(CA15-3) and carbohydrate antigen 125(CA125) and their clinical significance in papillary thyroid carcinoma (PTC). Methods The expressions of CA19-9, CA15-3 and CA125 were detected by immunohistochemical MaxVision method in 80 cases of PTC and 80 cases of benign thyroid lesions (BTL), including 34 cases of nodular goiter, 26 cases of Hashimoto's thyroiditis and 20 cases of follicular adenoma. The relationship between expressions of CA19-9, CA15-3 and CA125 and the clinical pathological characteristics were analyzed. Results The expression rates of CA19-9, CA15-3 and CA125 in 80 cases of PTC were 85%, 100%and 43.8%respectively, compared with BTL, the difference was statistically significant (P < 0.01). There was no significant correlation between expressions of CA19-9, CA15-3 and CA125 and age, gender, number and diameter of tumor nodules, lymph node metastasis, and TNM staging (P > 0.05). The sensitivity of CA19-9, CA15-3 and CA125 in the differential diagnosis of PTC and BTL were 85%, 100% and 43.8% respectively, and the specificity were 91.3%, 36.3%and 91.3%, respectively. Conclusion The expressions of CA19-9, CA153 and CA125 are helpful for the differential diagnosis of PTC and BTL.

Objective To investigate the feasibility in screening of normal ovarian tissues by evaluating the expressions of tumor-associated genes in tissues adjacent to human epithelial ovarian cancer of orthotopic implantation in nude mice.Methods Human epithelial ovarian cancer cell lines OVCAR3 were grown in subcutaneous tissues,and the tumor tissues were orthotopic implanted.The expressions of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were detected by immunohistochemical staining in proximal tissues,middle tissues,distal tissues adjacent to tumor,tumor tissues,and normal ovarian tissues of nude mice.Results 35 samples ovarian tissues with normal biopsy were gained from 40 cases of human epithelial ovarian cancers of orthotopic implantation model in nude mice.The expression rate of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were 95.0％ (38/40),95.0％ (38/40),75.0％ (30/40),85.0％ (34/40),77.5％ (31/40),and 77.5％ (31/40) in tumor tissues,respectively; 71.4％ (25/35),68.6％(24/35),57.1％ (20/35),62.9％ (22/35),60.0％ (21/35),and 57.1％ (20/35) in proximal tissues adjacent to tumor,respectively; 34.3％ (12/35),31.4％ (11/35),31.4％ (11/35),31.4％ (11/35),34.3％ (12/35),and 31.4％ (11/35) in middle tissues adjacent to tumor,respectively; and 25.7％ (9/35),22.9％ (8/35),25.7％ (9/35),25.7％ (9/35),28.6％(10/35),and 31.4％ (11/35) in distal tissues adjacent to tumor,re respectively.The expressions of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were all negative in 23 samples normal ovarian tissues adjacent to tumor.The expressions of CK-7,CA125,P53,survivin,MMP-2 and TIMP-2 in proximal tissues adjacent to tumor were lower than those in tumor tissues(P＜0.05),and higher than those in middle tissues and in distal tissues adjacent to tumor(P＜0.01).There were no expression difference between in middle tissues and in distal tissues (P＞0.05).The strong positive expressions of CK-7,CA125,and survivin were higher than those of P53,MMP-2,and TIMP-2 (P＜0.01).No significant difference was found in those expressions in the normal ovarian tissues adjacent to tumor gained from orthotopic implantation model with different severity.The expressions of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were all negative in 20 normal ovarian tissues of nude mice.Conclusions The expression of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 showed decreasing trend to non-cancer direction.Negative expressions of these tumor-associated genes can be used as standard in screening of normal ovarian tissues adjacent to tumor.Relative safe normal ovarian tissues can be obtained from the tissues adjacent to tumor.

OBJECTIVETo observe the expression of SIRT1 and mitochondrial uncoupling protein 2 (UCP2) in the liver of rats with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver (NAFLD) and explore the possible pathogenesis of T2DM and NAFLD.

METHODSTwenty-four male SD rat were randomized equally into control group and T2DM and NAFLD group (MC group), fed with standard diet and high-fat and high-sugar diet, respectively. At 12 weeks, the rats in MC group received a single dose of STZ (30 mg/kg) injected into the abdominal cavity for pancreatic islet destruction, and those in the control group received an equivalent volume of citric acid buffer. At 14 weeks, the body weight, FBG, hepatic function, blood lipid levels, FFAs, FINs and HOMA-IR of the rats were measured, and the liver pathology was examined with HE staining. The expression of SIRT1 and UCP2 in the rat liver was detected by immunohistochemistry and real-time quantitative PCR.

RESULTSAt 14 weeks, FBG, ALT, AST, TC, TG, LDL-C, VLDL, FFAs, FINs and HOMA-IR were significantly higher and HDL-C was significantly lower in MC group than in the control group (P<0.05). Pathological examination showed good structural integrity of the liver in the control group, and the liver cells were closely arranged with rich cytoplasm and round cell nuclei; in MC group, moderate to severe fatty liver was detected, and the liver cells showed severe ballooning degeneration and contained lipid vacuoles in the cytoplasm. The expression of SIRT1 was significantly lower and UCP2 significantly higher in MC group than in the control group (P<0.05).

CONCLUSIONThe expression of SIRT1 is significantly lowered and UCP2 increased in the liver of rats with T2DM and NAFLD.

Animals ; Diabetes Mellitus, Type 2 ; complications ; metabolism ; Fatty Liver ; complications ; metabolism ; Ion Channels ; metabolism ; Liver ; metabolism ; Male ; Mitochondrial Proteins ; metabolism ; Non-alcoholic Fatty Liver Disease ; Rats ; Rats, Sprague-Dawley ; Sirtuin 1 ; metabolism ; Uncoupling Protein 2

Objective To evaluate left atrial(LA) function in patients with prophase type 2 diabetes mellitus(T2DM) combinated with or without hypertension using left atrial volume tracking method(LAVT). Methods Thirty-one simple T2DM(T2DMI group) ,21 T2DM accompany with hypertension(T2DM2 group) and forty-five healthy subjects (control group) were enrolled in this study. Ultrasound LAVT(EUB-6500, Hitachi Medical Corporation) was applied to display and analyzed the LA volume loop imaging on the standard LV apical two and four chamber views. The maximal and the minimal LA volume (LAVmax, LAVmin) and the volume before LA contraction (LAVp) were recorded from the LA volume loop. The body surface area was used to correct these volume indexs. The LA reservoir function was assessed by calculating the total of LA filling volume (LAVItotal) and the expansion index(iLAVIe). The passive and active emptying percentage of the total emptying volume(LAVIpass, LAVIact) and the emptying index(iLAVIpass,iLAVIact) were caculated as the parameters of the LA conduit and booster pump function. Results Compared with the values in the control group, the LAVhotal,LAVIact were significantly higher and the LAVlpass,iLAVlpass were lower in the T2DM group (all P<0.05) ,while the iLAVIact was higher only seen in the T2DM2 group(P<0. 05). The LAVlact, iLAVIact were higher and the LAVIpass was lower in T2DM2 group than those in the T2DM1 group (all P<0.05). Conclusions The LA conduit hypofunction in primary in the prophase T2DM,when combinated with hypertension the LA constriction function compensatorily increased, LAVT can evaluate the function of LA in patients with T2DM accurately and rapidly.

Objective To assess the characteristics of left ventricular(LV) systolic dyssynchrony in patients with chronic heart failure (CHF) using two dimensional speckle-tracking imaging(2D-STI) and validate the correlation between LV systolic dyssynchrony and its ejection fraction (EF) measured by traditional two dimensional echocardiography. Methods Forty-two patients with CHF, which were divided into group CHF1 with 35% ＜EF≤50% and group CHF2 with EF≤35%, and 35 healthy subjects as control group were enrolled in this study. Two-dimensional echocardiography Simpson's method was used to measure EF of LV. The time from the onset of QRS complexes to systole peak strain rate from the longitudinal, radial and circumferential vectors(Tsrsl, Tsrsr, Tsrsc)was recorded and measured using 2D-STI, respectively. The standard deviation and the maximal temporal difference of Tsrsl, Tsrsr, Tsrsc (Tsrsl-SD,Tsrsr-SD,Tsrsc-SD,Tsrsl-diff,Tsrsr-diff, Tsrsc-diff)of 18 segments were calculated as indicator of LV systolic dyssynchrony. Results The indices of LV systolic dyssynchrony Tsrsl-SD,Tsrsl-diff, Tsrsr-SD, Tsrsr-diff,Tsrsc-SD,Tsrsc-diff in group CHF1 and CHF2 were significantly higher than those in the control group (P<0.05). Compared with group CHF1, those indices in CHF2 were significantly longer (P<0.05). Meanwhile, Tsrsl-SD, Tsrsr-SD, Tsrsc-SD(r = - 0.904～0.912, all P<0.05) and Tsrsl-diff, Tsrsr-diff, Tsrsc-diff(r = - 0.916～0.967, all P<0.01) had singnificantly negative correlations with LVEF, and the correlation coefficients between radial and circumferential 2D-STI dyssynchrony parameters and LVEF were higher than those between the longitudinal parameters and LVEF. Conclusions 2D-STI is a useful modality to evaluate the LV systolic asynchrony of the CHF and there is a good correlation between LVEF and the LV systolic dyssynchrony indices derived from 2D-STI.

Objective To investigate the application value of ultrasonic measurement of optic nerve sheath diameter (ONSD) in patients with craniocerebral trauma. Methods A total of 100 patients with craniocerebral trauma were selected as research subjects and randomly divided into control group and study group, with 50 patients in each group. Patients in the control group received invasive intracranial pressure (ICP) monitoring, while patients in the study group received invasive ICP monitoring combined with ultrasonic measurement of ONSD. Both groups were treated according to their actual conditions. The general information and treatment status of the two groups were observed, and the general information, ICP monitoring results, and ONSD ultrasonic measurement results of different ICP patients in the study group were compared. The correlation between ONSD and ICP in patients with craniocerebral trauma was analyzed, and the diagnostic efficacy of ONSD for ICP elevation in patients with craniocerebral trauma was also analyzed. Results At 28 days after treatment, the mean arterial pressure of the study group was higher than that of the control group, while the heart rate and respiratory rate were lower than those of the control group(P < 0.05). The mechanical ventilation time and ICU stay of the study group were shorter than those of the control group, the amount of mannitol used was less than that of the control group, and the ICP and 28-day mortality rate after treatment were lower than those of the control group (P < 0.05). Patients with ICP≥22 mmHg had higher ICP than those with ICP < 22 mmHg, and ONSD before and after the use of mannitol in different positions was greater than that in the ICP < 22 mmHg group (P < 0.05). There was a significant positive correlation between ONSD and ICP in patients with craniocerebral trauma (r=0.723, P < 0.001). The results of receiver operating characteristic curve analysis showed that the optimal cutoff value of ONSD for diagnosing ICP elevation was 5.25 mm, and the area under the curve was 0.879. Conclusion The combination of ICP monitoring and ultrasonic measurement of ONSD in the treatment of patients with craniocerebral trauma can effectively improve patients' vital signs, shorten the duration of mechanical ventilation and ICU stay, reduce the amount of mannitol used, and reduce the 28-day mortality rate. There is a significant positive correlation between ONSD and ICP in patients with craniocerebral trauma, and ONSD has a high diagnostic efficacy for ICP elevation.

Objective To explore the nosocomial infection knowledge of medical staff in tertiary hospitals of Beijing,and identify the influencing factors of nosocomial infection knowledge among medical staff.Methods By random sampling method,848 medical workers in a tertiary hospital were investigated by the self-designed questionnaire of medical workers′ knowledge about nosocomial infection control questionnaire.Results The average score of medical workers′ knowledge about nosocomial infection control was(68.78±11.70). The univariate analysis on the influencing factors of nosocomial infection knowledge showed that,the scores of medical workers′ knowledge about nosocomial infection were significantly different among workers in different departments and with different professional titles (t=6.715,53.166;P<0.05).Conclusions The medical workers′ knowledge about nosocomial infection in tertiary hospitals is at a medium level. Aimed at the items with low knowledge score in different groups and different medical workers,we should enhance the training among medical workers to reduce the occurrence of nosocomial infection and the incidence rate of nosocomial infection.

【Objective】 To investigate the correlation between body composition and thyroid function indicators in type 2 diabetic patients with euthyroidism of different genders. 【Methods】 Type 2 diabetic patients with euthyroidism who were hospitalized in the Endocrinology Department of The Second Affiliated Hospital of Xi’an Jiaotong University from February 2016 to September 2018 were enrolled in this study. Bioelectric impedance analysis was used to measure body composition, and the thyroid function indicators (FT3, FT4, and TSH) were tested. The male and female subjects were matched according to the ratio of 2:1 using the propensity score matching method, and the correlation between body composition and thyroid function indicators was studied in different genders by correlation analysis. 【Results】 The basal metabolic rate, trunk fat mass, fat-free mass, fat-free mass index, bone mass, water mass, total body muscle mass, skeletal muscle mass, and skeletal muscle index were positively correlated with FT3 in male patients (P<0.05). The percentage of body fat mass and fat mass index were positively correlated with FT3 and TSH (P<0.05), and the percentages of lean mass, water mass, and total body muscle mass were negatively correlated with FT3 and TSH (P<0.05), and the basal metabolic rate was negatively correlated with FT4 (P<0.05) in female. 【Conclusion】 In euthyroid type 2 diabetic patients, the correlation between body composition and thyroid function indicators are different between males and females. In males, only FT3 is positively correlated with basal metabolic rate, trunk fat mass, and fat free-related composition; while in females, both FT3 and TSH are positively correlated with fat-related composition, but negatively correlated with fat-free-related composition.