Objectives:To discuss the observation of patients receiving simultaneous pancreas-kidney transplantation for insulin-dependent diabetes mellitus complicated with end-stage renal failure.　Methods:The patient received simultaneous pancreas-kidney transplantation with enteric drainage of exocrine pancreatic secretions.　Results:The important aspects were as follows: monitoring the functions of the transplanted pancreas and kidney, observing the early characteristics of rejection, especially the pancreas, preventing thrombosis of blood vessels of the transplanted pancreas, digestive tract hemorrhage，pancreatitis, and preventing duodenal fistula. 　Conclusion:By careful clinical observation, postoperative complications could be found earlier, which aided the treatment and improved the prognosis.

Objective To construct a stable expression plasmids miR-218,to lay the experimental foundation for the expression and mechanism of miR-218 in human renal cell carcinoma.Methods The primers were designed by Has-miR-218 and the miR-218 fragment were amplified by PCR,and then which was connected with the carrier pcDNA3.1 (+) to build a stable expression plasmids.The recombinant plasmids were trasfected into renal cell carcinoma cell line 769-P,and the expression of miR-218 in these cells were detected.Results The plasmids were constructat successfully,which was determind by enzyme digestion and sequencing results.The constructed expression plasmids pcDNA3.1-miR-218 transfection of human renal cell carcinoma cell line 769-P,miR-218 cxpression level of cells was significantly increased after trasfected by recombinant plasmids carrying miR-218 gene (relative expression quantity was 1.64).Conclusion The miR-218 expression plasmids pcDNA3.1-miR-218 were successfully constructed,the plasmids can be applied to the study of miR-218 function and mechanism in renal cell carcinoma.

Objective To evaluate the performance of VITEK 2-Compact GN13 methods for testing imipenem susceptibility of Klebsiella pneumoniae and assess the reliability of its Advanced Expert System (AES).Methods A retrospective study was conducted with a total of 157K. pneumoniae strains, which were isolated from blood and intra-abdominal infections in the First Affiliated Hospital of Nanchang University from 2014 to 2015. Thein vitro minimum inhibitory concentration (MIC) values of imipenem were determined by disc diffusion, VITEK 2-Compact GN13 and broth microdilution methods, respectively. Categorical agreement (CA) rates of disc diffusion and VITEK 2-Compact GN13 methods were determined using broth microdilution as reference method. The genes encoding ESBLs and carbapenemase were screened by PCR and sequencing analysis. The phenotypic confirmatory tests such as modified Hodge test, PCR and DNA sequencing were used to confirm the resistance mechanism and evaluate the reliability of AES in interpreting the imipenem susceptibility of K. pneumoniae.Results Among the 157 isolates, 64 and 8 were identified as resistant and intermediate strains by broth microdilution method, respectively; 52 and 10 were tested as resistant and intermediate strains by disc diffusion method, respectively; 54 and 13 were determined as resistant and intermediate strains by VITEK 2-Compact GN13 method, respectively, while 70 and 3 were judged as resistant and intermediate strains by VITEK 2-Compact GN13 method plus AES validation. The CA of disc diffusion and VITEK 2-Compact GN13 methods compared with broth microdilution method were all higher than 90 %. However, the major error (ME) rate was 3.8 % and very major error (VME) rates were all 0.6 % in imipenem susceptibility testing by VITEK 2-Compact GN13 and disc diffusion. The imipenem susceptibility of 16 strains were modified by the AES, which eliminated 0.6 % VME, but increased major error by 1.3 % and minor error by 1.9 %. Phenotypic confirmatory tests showed that 75 % (12/16) of these strains were validated as producers of both ESBLs and carbapenemase, which was consistent with the result of AES validation. PCR and DNA sequencing analysis proved that 62.5 % (10/16) of these strains produce IMP-4/KPC-2 /NDM-1 and ESBLs.Conclusions Both disc diffusion and VITEK 2-Compact GN13 methods can be used for testing the imipenem susceptibility of K. pneumoniae isolates with reliable and accurate results. Attention should be paid to the possibility of ME and VME when testing imipenem susceptibility. The VME can be avoided by the AES mechanism. However, AES intervention will increase ME and minor error, which may be associated with decreased expression of carbapenemase.

Objective To explore the effects of miR-218 on biological functions of renal cell carcinoma cell line through regulating the expression levels of miR-218.Methods The pcDNA3.1-miR-218 was transfected into renal carcinoma cell line A498 and 769-P and the expression of miR-218 was detected.The cell activity,invasion,apoptosis and proliferation of transfected renal carcinoma cell line were analyzed in vitro.Results After plasmid transfected A498/769-P renal carcinoma cell line,the expression level of miR-218 (1.99,1.64) was significantly higher than that of the control group (1.00) (t =60.82,10.89,P ＜ 0.000 1) The cell viability (0.90±0.10,0.68±0.06) was lower than that of the control group (1.39±0.14,1.24±0.08) by CCK8 experiment (t =15.02,31.69,P ＜ 0.000 1).The cell invasion was lower than that of control group by Transwell experiment (t =15.78,18.80,P ＜ 0.000 1).The apoptosis ratio was higher by AnnxinV-FITC experiment,the apoptosis ration of control group and transfected group were respectively 0.25 ％,45.77 ％ in A498 cell line and 0.11％,45.57 ％ in 769-P cell line.The proliferation was lower than that of the control group (P ＜ 0.000 1).Conclusion Up-regulation of miR-218 expression can inhibit the growth of renal cell carcinoma cell line in vitro.

Objective To investigate the effect of Tongxinluo on carotid artery stenosis,and the levels of high sensitive C reactive protein(hs-CRP) and D-Dimer in patients with cerebral infarction.Methods 168 patients with cerebral infarction treated in this hospital from June 2014 to June 2015 were randomly divided into experimental group and control group,with 84 cases in each group.The patients in both group received routine treatment.In addition to that,patients in the experimental group also used Tongxinluo capsule for 6 months as a course of treatment.After a course of treatment,Doppler ultrasound diagnosis instrument was used to detect carotid arterial intima-media thickness,plaque area and carotid artery stenosis rate.Hs-CRP and D-Dimer levels were also detected.Results After treatment,the carotid arterial intima-media thickness,plaque area and carotid vascular stenosis rate in two group were significantly decreased(P<0.05),but the three indicators in experimental group were decreased more significantly(P<0.05).After a course of treatment,the levels of D-Dimer and hs-CRP in peripheral blood of the two groups were significantly decreased(P<0.05),but the content of D-Dimer and hs-CRP was much lower in the experimental group(P<0.05).Conclusion Tongxinluo treatment could effectively reduce the level of hs-CRP and D-Dimer in patients with cerebral infarction,and alleviate the carotid artery stenosis,which might be worthy of clinical application.

With cDNA from Phellodendron amurense seedlings treated with drought stress as tester and cDNA from this plant in normal growth as driver, we construct cDNA subtracted library using suppression subtractive hybridization (SSH). In the library, the rate of recombination was 95%, the size of inserts was 300-800 bp. Two hundred and sixty-five new genes were obtained by DNA sequencing 816 positive clones picked randomly, and partitioned to 16 classes after nucleotide Blast and BlastX homological analysis against NT, NR, SWISSPROT, KEGG database. Forty-four drought stress associated genes, such as heat shock protein cognate 70, dehydration responsive protein 22, universal stress protein, metallothionein II, late embryogenesis abundant protein, were obtained, which made 16.6% of the overall genes. These genes included osmotic regulator, signal component regulatory protein and antioxidant enzyme. The research had established a basis for cloning stress resistance genes and further studying genes expression in P. amurense seedlings under drought stress.
Adaptation, Physiological ; genetics ; Cloning, Molecular ; Droughts ; Gene Expression ; Gene Expression Profiling ; Gene Library ; Nucleic Acid Hybridization ; methods ; Phellodendron ; genetics ; growth & development ; physiology ; Seedlings ; genetics ; physiology

OBJECTIVETo compare and evaluate clinical applications of two definitions of metabolic syndrome in children and adolescents, which was developed by Pediatric Academy of Chinese Medical Association in 2012 (Chinese definition) and by International Diabetes Federation in 2007 (IDF definition), respectively.

METHODS593 obese children and adolescents aged 10 ≊16 y from July 2006 to December 2012 were enrolled in the study. The diagnostic concordance of two definitions for metabolic syndrome and individual components was estimated, and their sensitivity and specificity for detecting insulin resistance and early macrovascular complications were compared.

RESULTSThe concordance between two definitions for diagnosing metabolic syndrome was good (kappa=0.626); as for detecting the individual components, the Kappa concordance index were 1.000, 0.803, 0.780, 0.734 and 0.594 for hypertriglyceridemia, hyperglycemia, cholesterol abnormality and hypertension, respectively. The incidence of insulin resistance and early macrovascular complications, detected by the two definitions, were both increased with increasing number of abnormal components. The sensitivity and specificity for detecting insulin resistance in children with metabolic syndrome were 54.5% and 65.7% by Chinese definition, and 36.1% and 83.1% by IDF definition; while the sensitivity and specificity for detecting early macrovascular complications were 58.3% and 55.8% by Chinese definition, and 37.3% and 70.8% by IDF definition. After adjusting for age and sex, compared to the obese children and adolescents without metabolic syndrome, the odds ratios of insulin resistance and early macrovascular complications were 2.166 (P<0.001) and 1.771(P=0.008) for children with metabolic syndrome diagnosed by Chinese definition, and the odds ratio of insulin resistance and early macrovascular complications were 2.618 (P<0.001) and 1.357 (P=0.190) by IDF definition.

CONCLUSIONThe concordance between Chinese and IDF definitions for diagnosing metabolic syndrome in Chinese obese children and adolescents is good. Compared to IDF definition, Chinese definition is more sensitive for hypertension, hyperglycemia and hypercholesterolemia, thus it can more effectively detect insulin resistance and early macrovascular complication.

Adolescent ; Child ; Female ; Humans ; Insulin Resistance ; Male ; Metabolic Syndrome ; classification ; complications ; diagnosis ; Obesity ; complications ; Sensitivity and Specificity

Objective:To observe whether α1 adrenergic receptor (α1AR) blocker can reduce and antagonize portal hypertension caused by α1AR activation in rats, and to provide a new approach for the clinical treatment of portal hypertension.Methods:Phenylephrine was chosen as α1AR agonist, and alfuzosin was used as α1AR blocker. The route of administration was portal vein injection, and the pressure was measured by trans-portal vein puncture. According to random number table, 32 male Sprague-Dawley rats were divided into 4 groups: control group, portal hypertension model group, alfuzosin treatment group and alfuzosin prevention group. The portal venous pressure (PVP) was measured in all rats before administration. The rats in the control group were injected with 0.9% sodium chloride solution (1 L/g), and the rats in portal hypertension model group were injected with phenylephrine(1.5 μg/g), and the PVP of the above two groups was measured again at 5 and 10 min after injection. The rats in alfuzosin treatment group were injected with phenylephrine(1.5 μg/g), PVP was measured again at 5 min after administration, and then the rats were given alfuzosin(0.9 μg/g), PVP was measured again at 5 min after administration. The rats in alfuzosin prevention group were injected with alfuzosin(0.9 μg/g), PVP was measured at 1 min after administration, and then the rats were given phenylephrine(1.5 μg/g), PVP was measured again at 1, 5 and 10 min after phenylephrine injection respectively. One way analysis of variance and Dunnett- t test were used for statistical analysis. Results:The portal vein puncture was successfully performed in 4, 6, 8 and 5 rats in the control group, portal hypertension model group, alfuzosin treatment group and alfuzosin prevention group, respectively. The PVP of rats in portal hypertension model group at 5 and 10 min after phenylephrine injection was (18.045±7.636) and (15.515±5.440) mmHg (1 mmHg = 0.133 kPa), respectively, which were both higher than that before administration ((8.452±2.830) mmHg), and the differences were statistically significant ( t=2.89 and 2.82, both P<0.05). At 5 min after alfuzosin injection, the PVP of rats in the alfuzosin treatment group was (10.088±3.743) mmHg, which was lower than that of rats at 5 min after phenylephrine injection ((16.146±4.324) mmHg) and that of portal hypertension model group at 10 min after phenylephrine injection, and the differences were statistically significant ( t=3.00 and 2.22, both P<0.05). There were no significant differences in PVP in the alfuzosin prevention group before administration, at 1 min after injection of alfuzosin, and at 1, 5 and 10 min after injection of phenylephrine (all P > 0.05). Conclusions:α1AR is an important factor involved in the regulation of PVP, and its blockers can reduce and antagonize the portal hypertension caused by α1AR activation, which is of great significance in the prevention and treatment of portal hypertension progression in liver cirrhosis.

Objective:To observe the curative effect of exercise training combined with posture control among patients with displacement of the anterior disc of the temporomandibular joint (TMJ) without reduction.Methods:Forty-four patients with anterior TMJ disc displacement without reduction who had successfully been treated with manual repositioning were randomly divided into a control group and a treatment group, each of 22. Both groups underwent routine exercise training, while the experimental group was additionally provided with posture training five times a week for 4 weeks. After the 4th week of training both groups were evaluated using a visual analogue scale (VAS) and their maximum active mouth opening was compared. Six months later, MRI was performed to observe the disc-condyle relationship of the temporomandibular joint and its position.Results:①After 4 weeks of training, the average VAS scores of both groups were significantly lower than those before the training. The improvement in the treatment group′s average was significantly greater than among the control group. ②After the 4 weeks of training the average maximum active mouth opening of both groups had increased, with the improvement in the treatment group significantly greater. ③Six months later, 19 persons in the treatment group had a normal disc-condyle relationship, significantly more than the 13 in the control group.Conclusions:Posture control training can improve the effectiveness of sports training in maintaining manual repositioning of the TMJ after anterior disc displacement without reduction.

Objective To investigate the relationship between circadian sleep-wake biorhythm and prognosis in patients with middle cerebral artery acute ischemic stroke.Methods A total of 71 patients with acute ischemic stroke of middle cerebral artery were selected as the case group,and 67 patients without acute ischemic stroke and cerebrovascular stenosis were selected as the control group.According to the modified Rankin score at discharge,patients with acute ischemic stroke were subdivided into the good prognosis group(53 cases)and the poor prognosis group(18 cases).General clinical data of patients were collected,and differences of circadian rhythm,daytime sleep-wake rhythm,nighttime sleep-wake rhythm and circadian sleep-wake rhythm indexes were analyzed and compared between the two groups.Multivariate Logistic stepwise regression analysis was used to analyze prognostic factors of acute ischemic stroke in middle cerebral artery.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of relevant variables.Results Age,male ratio,hypertension,diabetes,hyperlipidemia,smoking and drinking history were significantly higher in the case group than those in the control group.Daytime stability(IS)in the case group was lower than that in the control group(P＜0.05).Daytime total sleep time,wake time after falling asleep,light sleep period,deep sleep period,non-rapid eye movement(NREM)sleep period,rapid eye movement(REM)sleep period and the proportion of deep sleep period,the proportion of REM sleep period were higher in the case group than those of the control group,while the REM sleep latency and the proportion of light sleep period were lower than those of the control group(P＜0.05).The total sleep time,wake time,light sleep period,NREM sleep period and REM sleep period were higher in the case group than those of control group,while the proportion of sleep latency and REM sleep period were lower than those of the control group(P＜0.05).The proportion of increased circadian sleep,increased daytime sleep and low sleep efficiency at night were higher in the case group than those of the control group(P＜0.05).Logistic stepwise regression analysis showed that daytime REM sleep was a prognistic factor in middle cerebral artery acute ischemic stroke.During daytime REM sleep,the area under ROC curve(AUC)was 0.705,the sensitivity was 0.811 and the specificity was 0.611.Conclusion After acute ischemic stroke of middle cerebral artery,the circadian sleep-wake rhythm is unbalanced,which is manifested as poor daytime stability,increased daytime sleep,increased circadian sleep and low sleep efficiency at night.Daytime REM sleep has predictive value for prognosis of acute ischemic stroke of middle cerebral artery.