ObjectiveTo explore the relationship between serum markers and liver fat content predicted by hepatorenal ratio in type 2 diabetic mellitus (T2DM) patients.Methods A total of 120 T2DM patients were recruited from January 2011 to September 2012 in the Affi liated Hospital of Qingdao University. The sagittal liver-right kidney diagrams of the patients were obtained by two-dimensional ultrasonic examination, and the hepatorenal ratio were analyzed by NIHimage. Then, the related serum markers were tested 24 hours later. The relationship between hepatorenal ratio and serum markers was analyzed by Spearman rank correlation on the patients of T2DM. Then, the affective factors on the hepatorenal ratio were analysed by multivariate linear regression analysis, with hepatorenal ratio as dependent variable, and the concentration of triglyceride (TG,X1) , total cholesterol (TC,X2), high density lipoprotein cholesterol (HDL-C,X3), low density lipoprotein cholesterol (LDL-C,X4), alanine aminotransferase (ALT,X5), aspartateaminotransferase (AST,X6), glutamyltransferase (γ-GT,X7) , and alkaline phosphatase (ALP,X8) as independent variables. The receiver operating characteristic curve (ROC) was drawn to diagnose the point of the hepatorenal ratio when the TG began to increase (>1.92 mmol/L).Results There was positive correlation between hepatorenal ratio and TG, AST, ALT,γ-GT (r=0.420,P=0.000;r=0.383,P=0.000;r=0.309,P=0.001;r=0.253,P=0.005), while no correlation between hepatorenal ratio and glycosylated hemoglobin, TC, HDL-C, LDL-C, ALP or blood uric acid (BUA) (r=0.0.067,P=0.368;r=0.145,P=0.115;r=?-0.148,P=0.106;r=0.002,P=0.986;r=0.160,P=0.081;r=0.064,P=0.489) were found; the linear regression analysis showed that TG level (X1) was the only markers which had correlation with hepatorenal ratio in the T2MD patients with the regression equation ofY=1.245+0.062X. The ROC curve analysis showed that the optimal cutoff value for hepatorenal ratio to in diagnosinge increased TG (>1.92 mmol/L) was 1.236 in T2DM patients, and the area under the curve was 0.677. The sensitivity and specifi city were 86.7% and 45.3% respectively. Conclusions Hepatorenal ratio can be a reliable indicator to predict liver fat content, which has correlation with TG, ALT, AST andγ-GT. The increased TG level can refl ect the increasing fat content in the liver, and TG begin to increase when the hepatorenal ratio reach 1.236.

[ ABSTRACT] AIM: To observe the effects of TNF-α/nuclear factor-κB( NF-κB) /matrix metalloproteinase-2 (MMP-2) pathway on the expression of MMP-2 in the mice with viral myocarditis.METHODS: Six-week-old inbred male mice were randomly assigned to control and myocarditis group.The mice in myocarditis group and control group were intra-peritoneally inoculated with 0.1 mL 10-5.69 TCID50 /mL coxsackievirus B3 and vehicle (PBS), respectively.Ten mice were sacrificed at the 4th and 10th days after injection.The blood and heart specimens were harvested.The serum content of TNF-αwas measured by ELISA.The myocardial levels of MMP-2, NF-κB p65 and IκBαwere determined by Western blot.RESULTS: Compared with control group, the protein expression of MMP-2 and NF-κB p65 in the myocardium and the serum content of TNF-αwere significantly increased in myocarditis group (P <0.05).The protein expression of IκBαwas lower in myocarditis group than that in control group (P <0.05).CONCLUSION: TNF-α, NF-κB p65 and MMP-2 were higher in the mice with acute viral myocarditis.The increased expression of them might be involved in the pathogene-sis of viral myocarditis.

Objective To investigate the protective role of hydrogen sulfide and the expression of cystathionine gamma-lyase/hydrogen sulfide pathway in a mouse model of myocarditis induced by Coxsachie -virus B3(CVB3).Methods A total of 110 five-week-old BALB/c male mice were randomly divided into four groups:the control group, viral myocarditis group, sodium bisulfide (NaHS) group (50 μmol/kg) and DL-propargylglycine (PAG) group (40 mg/kg).The experimental model of viral myocarditis was induced by intraperitoneal injection of CVB 3.Then the four groups were respectively administered with PBS , PBS, NaHS and PAG from day 1 to day 10 after infection.Blood and heart specimens were harvested from 10 mice of each group on day 4 and day 10 for evaluation of myocardial edema .The pathological changes in heart tis-sues were observed through hematoxylin-eosin staining.Levels of H2 S, IL-6 and TNF-αwere measured by ELISA.The expressions of CSE and CVB 3 at mRNA level were determined by quantitative real time PCR ( qRT -PCR ) analysis and the expression of CSE at protein level was detected by Western blot .Results Compared with the control group , the levels of H2 S and the expressions of CSE at mRNA and protein levels were down-regulated in mice with CVB 3-induced myocarditis .With the treatment of NaHS , the levels of H 2 S in serum and tissue were both up-regulated , and the histopathological damage was alleviated .However , PAG as an irreversible CSE inhibitor inhibited the expressions of H 2 S and CSE and aggravated myocardial injury , inflammatory cells infiltration and interstitial edema .Moreover , the RT-PCR analysis also showed that the expression of CVB3 at mRNA level was inhibited by NaHS but enhanced by PAG .Conclusion The expres-sion of CSE/H2 S pathway is down-regulated in mice with CVB 3-induced viral myocarditis .PAG could pro-mote virus propagation and exacerbate the disease through inhibiting the production of endogenous H 2 S, while NaHS as a H2 S donor has a protective effect on infected myocardium by suppressing virus replication at an early stage .

Objective To analyze correlation between ultrasound features and clinical lab indexes of refractory secondary hyperparathyroidism (SHPT).Methods Two-dimensional ultrasound and CEUS were performed in 30 patients with refractory SHPT before operation.The sum volume of hyperplastic parathyroid glands and sum volume of enhanced area of parathyroid glands in each patient were measured and calculated.Clinical lab indexes,including serum intact parathyroid hormone (iPTH),serum calcium,serum phosphorus,serum alkaline phosphatase (ALP) were recorded,and corrected serum calcium and corrected serum calcium-phosphorus product were calculated 2 days before operation.The correlation between sum volume of parathyroid glands and lab indexes was analyzed.Results There were positive correlations (r=0.48,0.50,both P=0.01) between sum volume of parathyroid glands,sum volume of enhanced area of parathyroid glands and iPTH level.No correlation was found between the volume of hyperplastic parathyroid glands and serum calcium,serum phosphorus,ALP,corrected serum calcium,nor calcium-phosphorus product (all P＞0.05).Conclusion The sum volume of parathyroid can reflect active state of parathyroid glands,which is helpful to diagnosis and monitoring refractory SHPT.

Objective To evalute the incidence and epidemiologic characteristics of Kawasaki disease (KD) in Wenzhou,China.Methods We used a questionnaire survey and reviewed the medical records and reports of all patients with KD diagnosed during the 10 year periods from January,2001 to December,2010.Results We studied 827 inpatients diagnosed with KD during the 10-years period from 2001 to 2010.There were 613 cases (74.12％) with complete KD.The ratio of male to female ratio was 2.28∶1.Age at onset ranged from 37 days to 13 years old,and the peak age group was 1 year old.The disease occurred in all of the seasons,but the peak was from April to June.The incidence of cardiovascular damage in acute KD was 34.6％,and the most common sequela was coronary artery dilatation.There were16 patients with coronary aneurysm.Fifty-three patients did not respond to immunoglobulin (6.4％),and 12 patients (1.5％) developed recurrent KD.After treatment,114 cases (13.8％) developed neutropenia.There were no deaths during hospitalization.Conclusion Patients with KD has become more and more in Wenzhou.Cardiovascular damages were similar to those in Beijing and Guangzhou,but higher than that reported in Japan.