Objective To investigate the expression of retinol binding protein 4(RBP-4) in maternal scrota and subcutaneous adipose tissue and its relationship with insulin resistance(IR)in gestational diabetes mellitus(GDM).Methods From May 2008 to April 2009,62 pregnant women who underwent elective cesarean section in the Department of Obstetrics.Affiliated Hospital of Qingdao University Medical College,were recruited,including 32 with GDM(GDM group)and 30 with normal glucose tolerance test(control group).Enzyme-linked immunosorbent assay(ELISA)was used to determine the serum concentrations of RBP-4 and radio immunoassay to measure the serum levels of fasting insulin (FINS).Fasting plasma glucose (FPG) was tested by glucose oxidase,and the Home model insulin resistance index(HOMA-IR)Was caleulated.Reverse transcription PCR(RT-PCR)and Western blot were applied to investigate the expression of RBP-4 mRNA and protein in subcutaneous adipose tissue.The correlations between the expression of RBP4 mRNA and protein in subcutaneous adipose tissue and the serum RBP-4 concentrations and HOMA-IR were analyzed. Results (1) The serum concentrations of RBP-4、FINS、FPG、HOMA-IR in GDM group were significantly higher compared with the control group [(27. 0 ±1.2) mg/L vs. (19.4±1.8)mg/L, (12.1±1.4)mU/L vs. (8.3±0.8)mU/L, (5.3±0.9)mmoL/L vs.(4. 1±0. 6) mmol/L, 2. 5 ± 0. 2 vs. 1.5 ± 0. 1, P < 0. 05, respectively]. ( 2 ) The expression of RBP-4 mRNA and protein in subcutaneous adipose tissue in the GDM group were significantly higher than that of the control group (0. 76 ± 0. 12 vs. 0. 53 ± 0. 06, 0. 74± 0. 09 vs 0. 54 ± 0. 06, P < 0. 05). (3) In the GDM group, the expression of both RBP-4 mRNA and protein in the subcutaneous adipose tissue were positively correlated with HOMA-IR(r=0. 575 and 0. 851, P < 0. 05). The serum concentration of RBP-4 were also positively correlated with HOMA-IR (r = 0. 635, P < 0. 05 ). No correlations was found between the expressions of RBP-4 mRNA and protein in subcutaneous adipose tissue with the serume RBP-4 concentrations. Conclusion High expression of RBP-4 mRNA in subcutaneous adipose tissue and the elevation of serum RBP-4 levels in GDM women may contribute to IR.

ObjectiveTo observe the relationship between neuronal function score,brain edema and aquaporin4(AQP4) expression of fluid percussion brain injury in rats.MethodsThe fluid percussion models of brain injury of rats were established by using the improved device.Nervous function score,brain water content,histological changes,AQP4 expression were observed by Shapira and Wahld method,dry-wet measure,light microscopy,immunohistochemistry and western blot at 1 h,6 h,12 h,24 h,3 d and 7 d after operation respectively.ResultsNervous function score in TBI group decreased at 12 h( 11.17 ± 1.32),reached its minimum at 24 h( 10.17± 0.75),and recoved partially at 3rd day( 10.66 ± 1.37 ).The water content obviusly increased in those of TBI group at 12h( (80.27 ±1.47)％ ),reached its peak at 24h( (82.19 ±0.97)％ ),and then began to drop at 3d ( (8 1.74 ± 1.69 ) ％ ),while Western blot showed that AQP4 immunoreactive expression obviusly increased at 12 h (OD:0.65 ±0.05),reached its maximum at 24h( OD:0.72 ±0.08),and decreased at 3d( OD:0.56 ±0.07),and immunohistochemistry showed the same trendency of AQP4 expression as that of Western blot.The linear regression analysis indicated that nervous function score had a negtive correlation with expression of AQP4 in edematous brain and change of brain water content respectively ( r =- 0.615,P ＜ 0.01 ; r =- 0.605,P ＜ 0.05 ).ConclusionNervous function score of fluid percussion brain injury in rats decrease,has negative relationship with brain edema and AQP4 expression,and possible mechanisms is that AQP4 is indirectly involed in nerve function impairment by mediating brain edema.

Objective:To examine the surgical treatment of Stanford type A aortic dissection (type A dissection) after thoracic endovascular aortic repair (TEVAR).Methods:The data of 58 patients with reoccurrence of type A dissection after TEVAR admitted into the Department of Cardiovascular Surgery, Henan Chest Hospital from February 2012 to January 2020 were analyzed retrospectively. There were 40 males and 18 females, aged (57.0±6.7) years (range: 31 to 71 years). The time between recurrence of type A dissection and TEVAR ( M( Q R)) was 37 days (72.8 months) (range: 1 h to 14 years). Forty-eight cases underwent emergency operation, 9 cases underwent sub-emergency operation, and 1 case died of dissection rupture on the way to the operating room. All 57 patients underwent radical treatment. Fifty-four cases underwent the frozen elephant trunk technique under deep hypothermia circulatory arrest and selective cerebral perfusion, and 3 cases (>65 years old) underwent arch debranch anastomosis+ascending aorta replacement+descending arch covered stent implantation under mild hypothermia. Results:The operation time was (445±32) minutes (range: 382 to 485 minutes), the aortic crossclamp time was (103±19) minutes (range: 89 to 133 minutes), the cardiopulmonary bypass time was (189±27) minutes (range: 162 to 221 minutes), and the intraoperative blood loss was (665±343) ml (range: 450 to 1 750 ml). Postoperative ICU stay time was 5 (6) days (range: 2 to 27 days), and postoperative hospital stay was 14.0 (4.5) days (range: 2 to 36 days). Three cases died, including 2 cases with severe brain complications and 1 case with systemic multiple organ failure caused by severe liver insufficiency and gastrointestinal hemorrhage. Postoperative follow-up was 0.5 to 7.0 years, which showed that 1 case had left coronary artery anastomotic stoma fistula 3 months after operation and underwent reoperation, 2 cases underwent thoracoabdominal aortic replacement again, and the rest of patients had no anastomotic stoma fistula and incomplete stent distortion and expansion on CT angiography. Four cases died during follow-up, and 1 case died of sudden cerebral infarction 2 years after operation.Conclusion:The recurrent type A dissection after TEVAR is mostly related to stent graft, and the patients can undergo operation actively with good prognosis.

Objective:To examine the surgical treatment of Stanford type A aortic dissection (type A dissection) after thoracic endovascular aortic repair (TEVAR).Methods:The data of 58 patients with reoccurrence of type A dissection after TEVAR admitted into the Department of Cardiovascular Surgery, Henan Chest Hospital from February 2012 to January 2020 were analyzed retrospectively. There were 40 males and 18 females, aged (57.0±6.7) years (range: 31 to 71 years). The time between recurrence of type A dissection and TEVAR ( M( Q R)) was 37 days (72.8 months) (range: 1 h to 14 years). Forty-eight cases underwent emergency operation, 9 cases underwent sub-emergency operation, and 1 case died of dissection rupture on the way to the operating room. All 57 patients underwent radical treatment. Fifty-four cases underwent the frozen elephant trunk technique under deep hypothermia circulatory arrest and selective cerebral perfusion, and 3 cases (>65 years old) underwent arch debranch anastomosis+ascending aorta replacement+descending arch covered stent implantation under mild hypothermia. Results:The operation time was (445±32) minutes (range: 382 to 485 minutes), the aortic crossclamp time was (103±19) minutes (range: 89 to 133 minutes), the cardiopulmonary bypass time was (189±27) minutes (range: 162 to 221 minutes), and the intraoperative blood loss was (665±343) ml (range: 450 to 1 750 ml). Postoperative ICU stay time was 5 (6) days (range: 2 to 27 days), and postoperative hospital stay was 14.0 (4.5) days (range: 2 to 36 days). Three cases died, including 2 cases with severe brain complications and 1 case with systemic multiple organ failure caused by severe liver insufficiency and gastrointestinal hemorrhage. Postoperative follow-up was 0.5 to 7.0 years, which showed that 1 case had left coronary artery anastomotic stoma fistula 3 months after operation and underwent reoperation, 2 cases underwent thoracoabdominal aortic replacement again, and the rest of patients had no anastomotic stoma fistula and incomplete stent distortion and expansion on CT angiography. Four cases died during follow-up, and 1 case died of sudden cerebral infarction 2 years after operation.Conclusion:The recurrent type A dissection after TEVAR is mostly related to stent graft, and the patients can undergo operation actively with good prognosis.