Objective To investigate the efficacies of laparoscopic sleeve gastrectomy + duodenojejunal bypass (DJB) and laparoscopic gastric bypass in the treatment of patients with non-obese type 2 diabetes mellitus (T2DM).Methods The clinical data of 42 patients with type 2 diabetes mellitus and body mass index (BMI) ＜ 30 kg/m2 received surgical treatment at the First Affiliated Hospital of Nanjing Medical University from January 2012 to June 2013 were retrospectively analyzed.Fifteen patients received laparoscopic sleeve gastrectomy + DJB (Sleeve + DJB group),and 27 received Roux-en-Y gastric bypass (RYGB group).The follow-up time for all the patients was more than 6 months.The decrease of BMI,complete remission of T2DM,decrease of fasting glycemia and glycosylated hemoglobin (HbAlc),postoperative nutritional condition and the incidence of complications of the 2 groups were compared.The measurement data were analyzed using the t test and the repeated measurement chi-square test.Results The operation time of the Sleeve + DJB group and the RYGB group were (137 ± 61)minutes and (89 ± 43) minutes,with significant difference between the 2 groups (t =6.158,P ＜ 0.05).No mortality and hemorrhage,bowel obstruction and anastomotic stenosis were detected.One patient was complicated with bile leakage in the Sleeve + DJB group,and was cured by conservative treatment 5 days later.The levels of fasting glucose before operation and at postoperative month 1,3,6 were (8.9 ± 0.7) mmol/L,(5.8 ± 1.3) mmoL/L,(5.6 ±1.8) mmol/L and (5.7 ± 0.3) mmol/L in the Sleeve + DJB group,and (9.9 ± 1.2) mmol/L,(6.9 ± 0.8) mmol/L,(6.6 ± 2.2) mmol/L and (5.6 ± 0.8) mmol/L,with no significant difference between the 2 groups (F =1.670,2.932,0.444,0.158,P ＞ 0.05).The levels of HbAle before operation and at postoperative months 1,3,6 were 7.4％± 1.4％,6.5％ ±0.6％,5.7％±0.5％,5.9％ ±0.6％ in the Sleeve + DJB group,and 7.7％± 2.0％,6.8％ ± 1.3％,5.7％±0.8％,5.6％ ± 1.1％ in the RYGB group,with no significant difference between the 2 groups (F =0.055,0.125,0.005,0.286,P ＞ 0.05).The remission rates of T2DM of the Sleeve + DJB group and the RYGB group were 14/15 and 74.1％ (20/27) at postoperative month 6,with no significant difference between the 2 groups (x2 =2.320,P ＞ 0.05).The decrease rate of BMI of the Sleeve + DJB group and the RYGB group were 18.2％±9.5％ and 21.2％ ± 4.9％,with no significant difference between the 2 groups (t =0.982,P ＞0.05).The numbers of patients with postoperative anaemia,avitaminosis and diarrhea were 0,0,2 in the Sleeve + DJB group and 3,2,6 in the RYGB group,with no significant difference between the 2 groups (x2=1.795,1.167,0.908,P ＞0.05).The BMIs of all the patients were above 19 kg/m2.Conclusion The effects and incidence of postoperative complications of Sleeve + DJB for the treatment of T2DM are comparable to those of RYGB.Sleeve + DJB has less interference on the nutritional condition of patients compared with RYGB.

Objective To investigate the relationship between androgen receptor CAG-gene polymorphism and androgen in male with salt sensitive hypertension.Methods Through the oral saline loading test and furosemide volume method male hypertension group were divided into salt-sensitive (SS group) and salt-insensitive (SR group).The samples from 161 males were selected in the study,including salt sensitive hypertension patients (SS group,61/161),salt-insensitive hypertension patients (SR group,40/161) and age-matched healthy samples (control group,60/161).All samples were sequenced with an analysis method (CAG) n repeated polymorphism,and determinated of total testosterone (TT) and free testosterone (FT) level in serum by electrochemiluminescence immunoassay.Results The number of CAG repeats was 14～34,average 22.4± 2.7.The CAG repeats of SS,SR and control group were 23.5±3.75,22.3±3.17 and 21.8±2.95,respectively.There were significant differences among the three groups (t=2.627～ 3.257,all P＜0.05).The level of TT and FT in SS and SR group were decreased compared with that of control group.At the same time,the level of SS group was lower,and there were significant differences among the three groups (t=2.524～ 3.826,all P＜0.05).Conclusion The androgen receptor gene repeat length and androgen levels are associated with male hypertension,especially salt-sensitive hypertension.Long (CAG) n repeat polymorphism maybe a genetic factor in the pathogenesis of hypertension.Plasma androgen levels may be used as a predictor of male salt sensitive hypertension.

OBJECTIVETo investigate the environmental and psychological risk factors for female infertility and to provide a scientific basis for the prevention and control of female infertility.

METHODSIn a hospital-based case-control study, a self-designed questionnaire was used to survey the cases and controls (1:1) with nation and age (± 2 years) as matching variables. Univariate and multivariate conditional logistic regression models were employed to analyze the datasets.

RESULTSThe univariate analysis showed that female infertility was related to the following factors: eating fried foods, alcohol consumption, smoking, staying up late, perm, housing decoration, contact with heavy metals, exposure to radiation, contact with pesticides, working in hot environment, mental stress, uneasiness, helplessness, and despair. The multivariate analysis showed that staying up late (OR = 2.937), housing decoration (OR = 2.963), exposure to radiation (OR = 2.506), contact with pesticides (OR = 2.908), and mental stress (OR = 4.101) were the main risk factors for female infertility. Furthermore, there was an interaction between staying up late and mental stress.

CONCLUSIONFemale infertility is caused by multiple factors including staying up late, housing decoration, exposure to radiation, contact with pesticides, and mental stress, and there is an interaction between staying up late and mental stress.

Adult ; Case-Control Studies ; Environmental Exposure ; analysis ; Female ; Humans ; Infertility, Female ; chemically induced ; etiology ; psychology ; Logistic Models ; Multivariate Analysis ; Risk Factors ; Stress, Psychological ; Surveys and Questionnaires

Objective:To investigate the preventive effect of tetramethylpyrazine (TMP) on hypoxic pulmonary hypertension in rats and the underlying mechanism.Methods:Thirty-six male Sprague-Dawley rats were randomly divided into three groups:the normal control group,hypobaric and hypoxic group and TMP group (100 mg·kg-1·d-1).After the animal models of hypobaric and hypoxic pulmonary hypertension were established,mean pulmonary artery pressure (mPAP),mean carotid artery pressure (mCAP),ratio of right ventricular/(lift ventricular + interventricular septum) (RVHI) and morphological changes of pulmonary vessels were observed and the rates of wall thickness/external diameter (WT%) and wall area/total vascular area (WA%) were calculated.The contents of nitric oxide (NO),endothelin-1 (ET-1),hypoxic-inducible factor-1 (HIF-1) and vascular endothelial growth factor (VEGF) were detected in serum after the 21-day treatment with TMP.Results:The values of mPAP,RVHI,WT% and WA% of hypobaric and hypoxic group were significant higher than those of the normal control group (P<0.05 or P<0.01),and those of TMP group were obviously lower than those of hypobaric and hypoxic group (P<0.05 or P<0.01).The condition of hypobaric and hypoxic had no significant effect on mCAP,and there were no significant differences among the groups (P>0.05).The values of NO in serum of hypobaric and hypoxic group was lower than those of the normal control group (P<0.05) and those of TMP group were obviously higher than those of hypobaric and hypoxic group (P<0.05).The values of ET-1,HIF-1α and VEGF in serum of hypobaric and hypoxic group were higher than those of the normal control group (P<0.05) and those of TMP group were obviously lower than those of hypobaric and hypoxic group (P<0.05).Conclusion:TMP can effectively prevent pulmonary hypertension induced by hypobaric and hypoxic and structural remodeling of pulmonary arterioles.The mechanism may be related to the content up-regulation of NO and activity down-regulation of ET-1,HIF-1α and VEGF in serum of rats.

Objective To detect the expression of metallothionein-3 (MT-3)mRNA in human esophageal squamous cell carcinoma. Methods Five cell lines of human esophageal cancer,TE-1,TE-13,TTN,ECA-109 (cell lines of esophageal squamous cell carcinoma) and OE33 (cell lines of esophageal adenocarcinoma),were used in this study. RT-PCR was employed to detect the expression of MT-3 mRNA. Peripheral blood monouclear cells from normal subjects were served as controls. Results Sequencing of RT-PCR product certified the gene of MT-3 mRNA. It was revealed by gel electrophoresis that there was expression of MT-3 mRNA in each cell line. The relative expression of MT-3 mRNA was 0.230?0.023,0.516?0.020,0.140?0.009,0.176?0.015 and 0.085?0.011 in cell lines of TE-1,TE-13,TTN,ECA-109 and OE33,respectively,significantly lower than that in controls (0.762?0.026) (P

Interactions between noroviruses (NoVs) and the receptors of histo-blood group antigens (HB-GAs) affect the infectivity and host susceptibility of NoVs. We elucidated the binding profile of a GII. 12 NoV to HBGAs. First, we synthesized the P domain sequence of the GII. 12 NoV strain Pune (GenBank accession number EU921353). Protein of the P domain was expressed in a prokaryotic system. Formation of the P particle was monitored by gel-filtration chromatography. Antiserum was prepared by immunization of mice with GII. 12 P particles. The binding profile of the GII. 12 NoV Pune strain was determined by binding of the P particle with a panel of saliva samples with various known HBGAs phenotypes. The GII. 12 NoV was bound strongly to saliva samples of subjects with B and AB types and weakly to A, O secretor, and non-secretor saliva samples, suggesting higher affinity with B antigen by GII. 12 NoV. These results were consistent with those determined by a previous crystallography study of GII. 12 NoV. These data suggested that individuals with B and AB blood types may be more susceptible to infection by GII. 12 NoV compared with those with other blood types. Our findings may provide a basis for the prevention and control of an epidemic of GII. 12 NoV.
Animals ; Blood Group Antigens ; metabolism ; Caliciviridae Infections ; metabolism ; virology ; Female ; Gastroenteritis ; metabolism ; virology ; Genotype ; Humans ; Mice ; Mice, Inbred BALB C ; Norovirus ; genetics ; metabolism ; Protein Binding ; Receptors, Virus ; metabolism ; Viral Proteins ; genetics ; metabolism

Objective To evaluate the effect on the reversal of left ventricular aneurysm (LVA) and on heart function of percutaneous coronary intervention (PCI) therapy at different time of acute myocardial infarction (AMI). Methods A total of 326 patients with primary anterior AMI-accompanied LVA diagnosed by left ventriculography (LVG) from January 2001 to July 2004 were enrolled in this study. They were randomized into 4 groups according to the time of accepting PCI:≤3 h group, 4-6 h group, 7-12 h group and one week group. At the baseline and 6 months after AMI, the parameters of left ventricular diastolic volume index (LVEDVI), left ventricular systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), left ventricular wall motion score (LVWMS) and left ventricular end diastolic pressure (LVEDP) were measured by LVG. The paradox volume index (PVI) was measured by equilibrium radionuclide at one week and 6 months after AMI.At 3 year following up to, the major adverse cardiac events (MACE) were recorded. Results At 6 months after PCI, the LVESVI, LVEDVI, WMS and LVEDP were all decreased while LVEF was increased in the four groups as compared with pre-PCl (P<0.05, respectively). Those parameters changed most obviously in ≤3 h group. At the 6th month after PCI, the PVI was lower in ≤3 h group (12.1±2.1)% than in 4-6 h, 7-12 h and one week group [(15.4±2.4)%, (16.5±2.5)% and (20.4±3.7)%, all P<0.05]. Within the 3 years follow-up, the MACE was significantly lower in 3 h, 4-6 h and 7-12 h groups than in one week group, and the mortality was lower too [(2.8%, 3.0% and 3.1% vs. 17.9%, all P<0.05]. Conclusions The early, fully and permanent open of the infraction-related artery can effectively inhibit the left ventricular remodeling process, prevent LVA formation, improve LV function and prognosis.

Objective To investigate the computed tomography (CT) features of autoimmune pancreatitis (AIP).Methods The CT imaging data of 33 patients with AIP confirmed by pathology and/or steroid therapy were retrospectively analyzed.Image analysis including the shape of pancreas, density of lesion, contrast enhancement, the changes of pancreatic duct and biliary duct, peripancreatic appearances and adjacent organ involvement.T test was performed for statistical analysis.Results Among 33 patients with AIP, 23 cases (70%) with pancreatic parenchyma diffuse enlargement, eight cases (24%) with partial enlargement and two cases (6%) with normal pancreas.The lesions appeared hypoattenuating or isoattenuating on plain CT scan.After contrast-enhanced scan, the average CT values of lesions were (75.7±17.0) Hu at arterial phase, which was lower than that of venous phase (90.7±12.0) Hu, and the difference was statistically significant (t=3.378,P=0.002).The lesions demonstrated as progressive enhancement at venous phase.Among 33 patients, the main pancreatic duct was visible in six patients (18%).Sixteen patients (48%) presented with intrahepatic and extrahepatic biliary tract dilatation caused by intrapancreatic common bile duct stenosis.Thickened envelope-like structure around the lesions, presenting as capsule sign was seen in 14 patients (42%).Extra-pancreatic organ involvement was found in seven patients including three cases of kidney involvement.After treated with steroid, seven patients repeated CT which showed different degrees of improvement.Conclusion The main CT findings of AIP are diffuse and partial enlargement of pancreas with progressive enhancement at venous phase, envelope-like structure around pancreas, and stenosis of intrapancreatic common bile duct, which are important in the diagnosis and differential diagnosis of AIP.

Pulmonary function testing (PFT) is a widely used method in early screening, severity evaluating and outcome predicting of lung diseases. In the practice of standardized training of pulmonary function tests, through the problem-based theory teaching and participative teaching and so on, we made the lung function inspection personnel to realize the examination operation essentials, and through situational teaching, we also cultivated the inspection personnel to master the communication skills with the children, so as to improve their professional quality, and ensure the effectiveness of the quality control of pulmonary function.

Background and purpose:Struma ovarii is a rare tumor, especially with extraovarian spreading. The study aimed to investigate the clinical and pathological features, diagnosis and differential diagnosis of ovarian goiter. Methods:Clinical and pathological features of 14 cases of benign and malignant ovarian goiter were observed. Immunohistochemical EnVision staining, PCR-DNA sequencing and review of related literature were also used. Results:In 14 cases of benign and malignant ovarian goiter, the average age of onset is 45.6 years (18-71 years old), and pelvic tumor is the main clinical manifestation. According to the related literature of diagnostic criteria, 12 cases are struma ovarii, which is consisted of hyperplasia of the thyroid tissue under microscopic examination, 1 case is malignant struma ovarii, which is papillary thyroid carcinoma by microscopic presentation, and 1 case is highly differentiated follicular carcinoma of ovarian origin (HDFCO), which is histological benign by microscopic presentation, but is malignant by biological behavior. Conclusion:Struma ovarii is a rare ovarian mondemal teratoma, with low rate of malignant change and beyond ovarian lesions disseminated microscopic histological benign struma ovarii is lower incidence, which has unique clinical and pathological features. Comprehensively considering the related literatures, this study indicates that the disease is in accordance with HDFCO. Struma ovarii prognosis is good, and should be differentiated from carcinoid and granular cell tumor.